Johnson, Clyde L.
Johnson, Clyde L. is an individual health care provider with primary practice located at 1051 Johnston Willis Dr. St. 200, Richmond VA 23235. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Johnson, Clyde L. can be contacted via phone (804) 320-2705.Contact Information
Primary practice address
1051 Johnston Willis Dr. St. 200
Richmond VA 23235
Phone: (804) 320-2705
Fax: (804) 330-2433
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 0101223144 | Virginia |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 0101-223144 | Virginia |
Profile Details
| NPI number | 1124007851 |
|---|---|
| LBN Legal business name | Johnson, Clyde L. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 11th, 2006 |
| Last updated | Mar 10th, 2010 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124007851 | NPPES |
| Virginia | MEDICAID | 7310871 |
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