Johnson, Casey Benjamin

Johnson, Casey Benjamin is an individual health care provider with primary practice located at 9430 Park West Blvd Ste 310 , Knoxville TN 37923-4203. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Johnson, Casey Benjamin can be contacted via phone (865) 690-5263.

Contact Information

Primary practice address
9430 Park West Blvd Ste 310 Knoxville TN 37923-4203
Phone: (865) 690-5263
Fax: (865) 588-3740
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 2291 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA2291 Tennessee

Profile Details

NPI number 1093054033
LBN Legal business name Johnson, Casey Benjamin
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 12th, 2013
Last updated Apr 18th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093054033 NPPES
Tennessee MEDICAID Q000510

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