Johnson, Jon David

Johnson, Jon David is an individual health care provider with primary practice located at 495 E Main St , Lake Butler FL 32054-1731. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Johnson, Jon David can be contacted via phone (386) 496-3211.

Contact Information

Primary practice address
495 E Main St Lake Butler FL 32054-1731
Phone: (386) 496-3211
Fax: (386) 496-1599
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 9197452 Florida

Profile Details

NPI number 1730179698
LBN Legal business name Johnson, Jon David
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2005
Last updated Oct 31st, 2013 - about 13 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 1730179698 NPPES
Florida MEDICAID 306277500
Florida MEDICAID 660083200

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