Johnson, Jennifer C

Johnson, Jennifer C is an individual health care provider with primary practice located at 616 W Forest Ave , Jackson TN 38301-3902. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Johnson, Jennifer C can be contacted via phone (731) 422-0406.

Contact Information

Primary practice address
616 W Forest Ave Jackson TN 38301-3902
Phone: (731) 422-0406
Fax: (731) 422-0471
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD05407 Tennessee

Profile Details

NPI number 1639147523
LBN Legal business name Johnson, Jennifer C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2006
Last updated Nov 10th, 2009 - about 15 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 1639147523 NPPES
Tennessee MEDICAID 3056497

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