person
Jonathan Idicula Johnson, DO
Student in an Organized Health Care Education/Training Program in Winston Salem, North Carolina
NPI 1942051107

Jonathan Idicula Johnson is a Student in an Organized Health Care Education/Training Program based in Winston Salem, NC. Jonathan Idicula Johnson practices in Winston Salem, NC and has the professional credentials of DO. The NPI Number for Jonathan Idicula Johnson is 1942051107 and holds a License No. (North Carolina).

The current practice location address for Jonathan Idicula Johnson is 1920 W 1St St Fl 3, Winston Salem, NC and can be reached out via phone at 336-716-4479.

Location: 1920 W 1St St Fl 3, Winston Salem, NC, 27104-4220
person
Provider Profile Details
NPI Number
1942051107
Provider Name
Jonathan Idicula Johnson
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
1920 W 1St St Fl 3, Winston Salem, NC, 27104-4220
Phone Number
336-716-4479
Fax Number
Provider Enumeration Date
03/27/2024
Last Update Date
04/14/2024
institution
Provider Business Practice Location Address Details
Address
1920 W 1St St Fl 3
City
State
Zip
27104-4220
Phone Number
336-716-4479
Fax Number
person
Provider Business Mailing Address Details
Address
1920 W 1St St Fl 3
City
State
Zip
27104-4220
Phone Number
336-716-4479
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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