Marvin W. Johnson M.D.

LBN: Marvin W. Johnson M.D.
Marvin W. Johnson M.D. is an health care organization with primary practice located at 850 E Main St , Lake Butler FL 32054-1353. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Marvin W. Johnson M.D. can be contacted via phone (386) 496-2406, or through Johnson, Marvin Wade via phone (386) 496-2406.

Contact Information

Primary practice address
850 E Main St Lake Butler FL 32054-1353
Phone: (386) 496-2406
Fax: (386) 496-3362
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Marvin Wade
Phone: (386) 496-2406

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME0011466 Florida

Profile Details

NPI number 1265979041
LBN Legal business name Marvin W. Johnson M.D.
DBA Doing business as
Authorized official Johnson, Marvin Wade
Entity Organization
Organization subpart 1 No
Enumeration date Jan 31st, 2017
Last updated Jan 31st, 2017 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265979041 NPPES
Florida Other 53331 BCBS
Florida MEDICAID 065935500 BCBS

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