Idella Johnson, PA-C

NPI #1073554523 in Tazewell, Tennessee

Provider Information

NPI Number: 1073554523
Entity Type: Individual
Name: Idella Johnson, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Jun 8, 2006
Last Updated: Dec 16, 2015

Practice Location

Address: 1610 TAZEWELL RD
Address 2: SUITE 201
City: Tazewell
State: Tennessee
ZIP Code: 37879-3600
Phone: (423) 626-8393

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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