Marvin W. Johnson M.d.

NPI #1265979041 in Lake Butler, Florida

Provider Information

NPI Number: 1265979041
Entity Type: Organization
Organization Name: Marvin W. Johnson M.d.
Primary Specialty: Family Medicine
Enumeration Date: Jan 31, 2017
Last Updated: Jan 31, 2017

Practice Location

Address: 850 E MAIN ST
City: Lake Butler
State: Florida
ZIP Code: 32054-1353
Phone: (386) 496-2406

Authorized Official

Name: DR. MARVIN WADE JOHNSON
Title: MEDICAL DOCTOR
Phone: (386) 496-2406

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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