Johnson, Vernon Latrell

Johnson, Vernon Latrell is an sole proprietor health care provider with primary practice located at 5050 Poplar Ave Suite 718, Memphis TN 38157-0101. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Johnson, Vernon Latrell can be contacted via phone (901) 443-0475.

Contact Information

Primary practice address
5050 Poplar Ave Suite 718 Memphis TN 38157-0101
Phone: (901) 443-0475
Fax: (901) 509-2926
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X R3CO7 Missouri
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X R3C07 Missouri
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X R3C07 Missouri

Profile Details

NPI number 1144333030
LBN Legal business name Johnson, Vernon Latrell
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 16th, 2006
Last updated Aug 1st, 2014 - about 12 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 1144333030 NPPES
Missouri MEDICAID 201787314

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