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John P Johnson, PA-C
Medical Physician Assistant in Moline, Illinois
NPI 1821084047

John P Johnson is a Medical Physician Assistant based in Moline, IL and is specialized in Medical. John P Johnson practices in Moline, IL and has the professional credentials of PA-C. The NPI Number for John P Johnson is 1821084047 and holds a License No. 085002074 (Illinois).

The current practice location address for John P Johnson is 4376 7Th St, Moline, IL and can be reached out via phone at 309-762-0777.

Location: 4376 7Th St, Moline, IL, 61265-6867
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Provider Profile Details
NPI Number
1821084047
Provider Name
John P Johnson
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
4376 7Th St, Moline, IL, 61265-6867
Phone Number
309-762-0777
Fax Number
Provider Enumeration Date
09/22/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
385000978 01 IL CONTROLLED SUBSTANCE#
421060724A3 01 IL JOHN DEERE HEALTH
IL01A3 01 IL JOHN DEERE EDI#
Q02637 01 UPIN
421060724 01 IA BILLING TAX ID FOR CHC
93263 01 IA IA BC/BS SEEN IN RI
93251 01 IA IA BC/BS SEEN IN MOLINE
090218 01 HEALTH ALLIANCE
242060 01 IL MIDLAND'S CHOICE
institution
Provider Business Practice Location Address Details
Address
4376 7Th St
City
State
Zip
61265-6867
Phone Number
309-762-0777
Fax Number
person
Provider Business Mailing Address Details
Address
4376 7Th St
City
State
Zip
61265-6867
Phone Number
309-762-0777
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
085002074 (Illinois)
Definition
Definition to come...
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