Dr. Bruce W Johnson, MD
Family Medicine in Ooltewah, TN. Individual provider (NPI-1).
NPI number1619954575
StatusActive
Last updated in NPPESJun 2, 2010
Details
- NPI
- 1619954575
- Entity type
- Individual (NPI-1)
- Name
- Dr. Bruce W Johnson
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 30, 2005
- Last updated
- Jun 2, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 28377 | TN | Yes |
Practice location
6401 Mountain View RoadSuite 109
Ooltewah, TN 37363-6685
Phone 423-495-5951 · Fax 423-495-5999
Mailing address
6401 Mountain View RoadSuite 109
Ooltewah, TN 37363-6685
Phone 423-495-5951 · Fax 423-495-5999
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