Johnson, Joel David

Johnson, Joel David is an individual health care provider with primary practice located at 618 S Broadway Ave , Tyler TX 75701-1665. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Johnson, Joel David can be contacted via phone (903) 596-9900.

Contact Information

Primary practice address
618 S Broadway Ave Tyler TX 75701-1665
Phone: (903) 596-9900
Fax: (903) 596-0242
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X G7829 Texas
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X G7829 Texas

Profile Details

NPI number 1922090497
LBN Legal business name Johnson, Joel David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Oct 17th, 2011 - about 15 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 1922090497 NPPES
Texas MEDICAID 079835701

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