William G Johnson M.d. P.c | |
18710 Linden Blvd Saint Albans NY 11412-4026 | |
(718) 723-1769 | |
(718) 723-9056 |
Full Name | William G Johnson M.d. P.c |
---|---|
Speciality | Internal Medicine |
Location | 18710 Linden Blvd, Saint Albans, New York |
Authorized Official Name and Position | William G Johnson (PRESIDENT/OWNER/PHYSICIAN) |
Authorized Official Contact | 7187231769 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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William G Johnson M.d. P.c 18710 Linden Blvd Saint Albans NY 11412-4026 Ph: (718) 723-1769 | William G Johnson M.d. P.c 18710 Linden Blvd Saint Albans NY 11412-4026 Ph: (718) 723-1769 |
NPI Number | 1811337801 |
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Provider Enumeration Date | 07/05/2013 |
Last Update Date | 07/05/2013 |
Medicare PECOS PAC ID | 6305087206 |
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Medicare Enrollment ID | O20130718000272 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811337801 | NPI | - | NPPES |
01120878 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 161045 (New York) | Primary |
Provider Name | William G Johnson |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1992791420 PECOS PAC ID: 2769471879 Enrollment ID: I20040512000231 |
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