Johnson, Douglas L

Johnson, Douglas L is an individual health care provider with primary practice located at 1301 Plantation Island Dr S Suite 101, St Augustine FL 32080-3108. He recently has 3 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Plastic Surgery Within the Head and Neck. Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery is his primary health care specialty. Johnson, Douglas L can be contacted via phone (904) 460-0505.

Contact Information

Primary practice address
1301 Plantation Island Dr S Suite 101 St Augustine FL 32080-3108
Phone: (904) 460-0505
Fax: (904) 460-0506
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X DN15568 Florida
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X DN15568 Florida
Allopathic & Osteopathic Physicians / Plastic Surgery Within the Head and Neck 2082S0099X DN15568 Florida

Profile Details

NPI number 1730292517
LBN Legal business name Johnson, Douglas L
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2006
Last updated Jun 23rd, 2008 - about 16 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 1730292517 NPPES
Other 1615570 UNITED CONCORDIA
Other 000415568 UNITED CONCORDIA
Other 84009 UNITED CONCORDIA
Other B15568-1 UNITED CONCORDIA
Other P00237430 UNITED CONCORDIA
Other 20-0618977 UNITED CONCORDIA

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