Provider Demographics
NPI:1124303391
Name:DR STEVEN EUGENE JOHNSON PC
Entity type:Organization
Organization Name:DR STEVEN EUGENE JOHNSON PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INCORPORATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:334-524-1696
Mailing Address - Street 1:2100 DATA PARK
Mailing Address - Street 2:#100
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-2519
Mailing Address - Country:US
Mailing Address - Phone:205-985-9888
Mailing Address - Fax:205-985-9895
Practice Address - Street 1:2100 DATA PARK
Practice Address - Street 2:#100
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-2519
Practice Address - Country:US
Practice Address - Phone:205-985-9888
Practice Address - Fax:205-985-9895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-19
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2301111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty