Basic Information
| Provider Information | |||||||||
| NPI: | 1841456225 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | F. ALLEN JOHNSTON, MD, APMC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1940 ONEAL LN | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708163201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2257516666 | ||||||||
| FaxNumber: | 2257516680 | ||||||||
| Practice Location | |||||||||
| Address1: | 1940 ONEAL LN | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708163201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2257516666 | ||||||||
| FaxNumber: | 2257516680 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2008 | ||||||||
| LastUpdateDate: | 05/07/2010 | ||||||||
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| AuthorizedOfficialLastName: | LOSAVIO | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO/OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 2257555104 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | CEO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 015408 | LA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 10450 | 01 | LA | CDS | OTHER | AJ9169485 | 01 | LA | DEA | OTHER | 1317012 | 05 | LA | MEDICAID |