Individual provider · Type 1 NPI
Ian James Johnson, MD
Pediatric Adolescent Medicine Physician · Patrick Afb, FL
Practice location
1381 South Patrick Dr, Patrick Afb, 45 Medical Group
Patrick Afb, FL 32925-4162
Fax (321) 494-8533
Mailing address
4066 Hield Rd NW
Palm Bay, FL 32907-6307
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Adolescent Medicine Physician Primary | 2080A0000X | G0440 (TX) |
Pediatric Adolescent Medicine Physician: A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
About NPI 1265404990
Ian James Johnson, MD's National Provider Identifier is 1265404990, issued on Feb 6, 2006. The primary taxonomy on file is Pediatric Adolescent Medicine Physician (2080A0000X), and the practice location is in Patrick Afb, FL. The record was last updated on Jun 25, 2009.