Provider Demographics
NPI:1215148705
Name:DONALD E JOHNSON, MD PL
Entity type:Organization
Organization Name:DONALD E JOHNSON, MD PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-683-5220
Mailing Address - Street 1:PO BOX 5270
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34611-5270
Mailing Address - Country:US
Mailing Address - Phone:352-683-5220
Mailing Address - Fax:352-666-6513
Practice Address - Street 1:10495 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-5045
Practice Address - Country:US
Practice Address - Phone:352-683-5220
Practice Address - Fax:352-666-6513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F74036Medicare UPIN
23794VMedicare PIN
FLK4394Medicare ID - Type Unspecified