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Contact Information

IAN J JOHNSON, MD
1381 SOUTH PATRICK DR, PATRICK AFB
45 MEDICAL GROUP
PATRICK AFB, FL32925-4162
 Phone: 321-494-8152
 Fax: 321-494-8533
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adolescent Medicine

2080A0000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for IAN J JOHNSON · (Male)

NPI Number 1265404990
Status Active
Credentials MD
Entity Individual
Enumeration date 02/06/2006
Last updated 06/25/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • TX License # G0440
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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