Dr Joel David Johnson, MD | |
618 S Broadway Ave, Tyler, TX 75701-1665 | |
(903) 596-9900 | |
(903) 596-0242 |
Full Name | Dr Joel David Johnson |
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Gender | Male |
Speciality | Internal Medicine - Critical Care Medicine |
Location | 618 S Broadway Ave, Tyler, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1922090497 | NPI | - | NPPES |
079835701 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RC0200X | Internal Medicine - Critical Care Medicine | G7829 (Texas) | Primary |
207RP1001X | Internal Medicine - Pulmonary Disease | G7829 (Texas) | Secondary |
Entity Name | East Texas Medical Center Healthcare Associates |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1124062484 PECOS PAC ID: 3678486222 Enrollment ID: O20031114000152 |
Entity Name | Etmc Physician Group, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1609382662 PECOS PAC ID: 4486915600 Enrollment ID: O20180305002106 |
Mailing Address | Practice Location Address |
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Dr Joel David Johnson, MD 618 S Broadway Ave, Tyler, TX 75701-1665 Ph: (903) 596-9900 | Dr Joel David Johnson, MD 618 S Broadway Ave, Tyler, TX 75701-1665 Ph: (903) 596-9900 |
Ifeatu Uchenna Oti, MD Critical Care Medicine Medicare: Accepting Medicare Assignments Practice Location: 1133 Medical Dr, Tyler, TX 75701 Phone: 903-595-5486 Fax: 903-595-5128 | |
Preetham Reddy Muskula, MD Critical Care Medicine Medicare: Accepting Medicare Assignments Practice Location: 2608 Mcdonald Rd, Tyler, TX 75701 Phone: 903-595-5514 Fax: 903-262-3715 | |
Dr. Varalaxmi Bhavani Nannaka, M.D. Critical Care Medicine Medicare: Accepting Medicare Assignments Practice Location: 912 S Fleishel Ave, Tyler, TX 75701 Phone: 903-592-6901 | |
David A Brickey, DO Critical Care Medicine Medicare: Accepting Medicare Assignments Practice Location: 800 E Dawson St, Tyler, TX 75701 Phone: 903-525-1914 | |
Randy Craig Randall, MD Critical Care Medicine Medicare: Medicare Enrolled Practice Location: 1783 Troup Highway, Tyler, TX 75701 Phone: 903-595-2283 Fax: 903-595-1063 | |
Nabeel K Ahmed, M.D. Critical Care Medicine Medicare: Accepting Medicare Assignments Practice Location: 1133 Medical Dr, Tyler, TX 75701 Phone: 903-595-5486 Fax: 903-595-5128 | |
Dr. Amanda Nicole Long, D.O. Critical Care Medicine Medicare: Accepting Medicare Assignments Practice Location: 619 S Fleishel Ave, Ste 327, Tyler, TX 75701 Phone: 903-510-1173 |