Johnson, Jeremiah J
Johnson, Jeremiah J is an individual health care provider with primary practice located at 1100 Wilford Hall Loop , Lackland Afb TX 78236-5638. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Johnson, Jeremiah J can be contacted via phone (210) 292-7331.Contact Information
Primary practice address
1100 Wilford Hall Loop
Lackland Afb TX 78236-5638
Phone: (210) 292-7331
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 207PP0204X | N4498 | Texas |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | N4498 | Texas |
Profile Details
| NPI number | 1104816362 |
|---|---|
| LBN Legal business name | Johnson, Jeremiah J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 27th, 2005 |
| Last updated | Nov 8th, 2023 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104816362 | NPPES |
| North Carolina | MEDICAID | 5907026 | |
| North Carolina | MEDICAID | N0076G |
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