Basic Information
| Provider Information | |||||||||
| NPI: | 1316459829 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GERALD E JOHNSON MD PLLC | ||||||||
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| OtherOrganizationName: | ALL HEART PEDIATRIC CARDIOLOGY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6148 LEE HWY STE 206 | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374216515 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234983300 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6148 LEE HWY STE 206 | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374216515 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234983300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2017 | ||||||||
| LastUpdateDate: | 06/29/2022 | ||||||||
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| AuthorizedOfficialLastName: | JOHNSON | ||||||||
| AuthorizedOfficialFirstName: | CATHARINE | ||||||||
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| AuthorizedOfficialTitleorPosition: | RN/OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4234983300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | RN | ||||||||
| NPICertificationDate: | 06/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0202X | 32248 | TN | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Cardiology |
No ID Information.