Johnson, Jon Bradley
Johnson, Jon Bradley is an individual health care provider with primary practice located at 2516 Broadmoor Blvd , Monroe LA 71201-2988. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Johnson, Jon Bradley can be contacted via phone (318) 387-9420.Contact Information
Primary practice address
2516 Broadmoor Blvd
Monroe LA 71201-2988
Phone: (318) 387-9420
Fax: (318) 323-8216
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 021605 | Louisiana |
Profile Details
| NPI number | 1629014626 |
|---|---|
| LBN Legal business name | Johnson, Jon Bradley |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 20th, 2006 |
| Last updated | Jun 12th, 2019 - about 5 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 | 1629014626 | NPPES |
| Louisiana | MEDICAID | 1698326 |
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