Johnson, Vernon Latrell
Johnson, Vernon Latrell is an sole proprietor health care provider with primary practice located at 5050 Poplar Ave Suite 718, Memphis TN 38157-0101. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Johnson, Vernon Latrell can be contacted via phone (901) 443-0475.Contact Information
Primary practice address
5050 Poplar Ave Suite 718
Memphis TN 38157-0101
Phone: (901) 443-0475
Fax: (901) 509-2926
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | R3CO7 | Missouri |
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | R3C07 | Missouri |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | R3C07 | Missouri |
Profile Details
| NPI number | 1144333030 |
|---|---|
| LBN Legal business name | Johnson, Vernon Latrell |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 16th, 2006 |
| Last updated | Aug 1st, 2014 - about 10 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 | 1144333030 | NPPES |
| Missouri | MEDICAID | 201787314 |
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