Provider Demographics
NPI:1154544401
Name:JOHNSTON, JAMES MICHAEL JR (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:MICHAEL
Last Name:JOHNSTON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 55310
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5310
Mailing Address - Country:US
Mailing Address - Phone:205-731-9701
Mailing Address - Fax:205-297-9411
Practice Address - Street 1:1600 7TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1711
Practice Address - Country:US
Practice Address - Phone:205-939-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006031525207T00000X
AL30171207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051107795OtherBCBS
MS00189068Medicaid
AL120556Medicaid
AL051107799OtherBCBS
AL051107795OtherBCBS OF ALABAMA
AL120554Medicaid
AL051107798OtherBCBS
AL120555Medicaid
AL051107797OtherBCBS
AL120551Medicaid
MS00189068Medicaid