Provider Demographics
NPI:1538152483
Name:STRICKLAND, JOHNNIE WAYNE JR (MD)
Entity type:Individual
Prefix:DR
First Name:JOHNNIE
Middle Name:WAYNE
Last Name:STRICKLAND
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 680519
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36068-0519
Mailing Address - Country:US
Mailing Address - Phone:334-361-8555
Mailing Address - Fax:866-923-0406
Practice Address - Street 1:270 INTERSTATE COMMERCIAL PARK LOOP
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-7361
Practice Address - Country:US
Practice Address - Phone:334-361-8225
Practice Address - Fax:334-361-0377
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-25
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL16079207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000026728Medicaid
AL051026728OtherBCBS OF ALABAMA
ALE91876Medicare UPIN
AL051026728OtherBCBS OF ALABAMA