DR. Marvin Wade Johnson SR., M.D.

NPI #1346244092 in Lake Butler, Florida

Provider Information

NPI Number: 1346244092
Entity Type: Individual
Name: DR. Marvin Wade Johnson SR., M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Family Medicine
Credential: M.D.
Enumeration Date: Jun 10, 2005
Last Updated: Jun 30, 2010

Practice Location

Address: 850 E MAIN ST
Address 2: LOT 1
City: Lake Butler
State: Florida
ZIP Code: 32054-1348
Phone: (386) 496-2406

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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Organizations

Provider Name	Specialty	City
Marvin W. Johnson M.d.	Family Medicine	Lake Butler	AI Deep Dive
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