Dr Marvin Wade Johnson Sr, MD is a
Family Medicine physician based in Lake Butler, Florida. Dr Marvin Wade Johnson Sr is licensed to practice in Florida (license number ME0011466) and his current practice location is 850 E Main St, Lot 1, Lake Butler, Florida. He can be reached at his office (for appointments etc.) via phone at
(386) 496-2406.
NPI number for Dr Marvin Wade Johnson Sr is 1346244092 and his current mailing address is Po Box 478, Lake Butler, Florida. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1346244092.
Physician's Profile
| Full Name | Dr Marvin Wade Johnson Sr |
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| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 850 E Main St, Lake Butler, Florida |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1346244092
- Provider Enumeration Date: 06/10/2005
- Last Update Date: 06/30/2010
Medical Identifiers
Medical identifiers for Dr Marvin Wade Johnson Sr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1346244092 | NPI | - | NPPES |
| 065935500 | Medicaid | FL | |
| 53331 | Other | FL | BCBS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | ME0011466 (Florida) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Marvin Wade Johnson Sr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Marvin Wade Johnson Sr, MD
Po Box 478,
Lake Butler, FL 32054-0478
Ph: (386) 496-2406 | Dr Marvin Wade Johnson Sr, MD
850 E Main St, Lot 1,
Lake Butler, FL 32054-1348
Ph: (386) 496-2406 |
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