Johnson, Jerry C

Johnson, Jerry C is an individual health care provider with primary practice located at 3615 Chestnut St Ralston Penn Center, Philadelphia PA 19104. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is his primary health care specialty. Johnson, Jerry C can be contacted via phone (215) 662-2746.

Contact Information

Primary practice address
3615 Chestnut St Ralston Penn Center Philadelphia PA 19104
Phone: (215) 662-2746
Fax: (215) 349-5648
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X MD019829E Pennsylvania
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD019829E Pennsylvania

Profile Details

NPI number 1669415972
LBN Legal business name Johnson, Jerry C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Mar 23rd, 2012 - about 13 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1669415972 NPPES
Pennsylvania MEDICAID 0007361000007

Popular Providers