Johnson, Rosa Lee
Johnson, Rosa Lee is an individual health care provider with primary practice located at 4 Longmeadow Village Dr , Niles MI 49120-7809. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Johnson, Rosa Lee can be contacted via phone (269) 684-6000.Contact Information
Primary practice address
4 Longmeadow Village Dr
Niles MI 49120-7809
Phone: (269) 684-6000
Fax: (269) 684-1388
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 5101015534 | Michigan |
Profile Details
| NPI number | 1003981176 |
|---|---|
| LBN Legal business name | Johnson, Rosa Lee |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 22nd, 2006 |
| Last updated | Jun 8th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003981176 | NPPES |
| Michigan | MEDICAID | 4960356-11 |
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