Provider Demographics
NPI:1225019086
Name:JOHNSON-CRUM, SONYA LASHAWN (MD)
Entity Type:Individual
Prefix:DR
First Name:SONYA
Middle Name:LASHAWN
Last Name:JOHNSON-CRUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SONYA
Other - Middle Name:LASHAWN
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:9448 DAYTON PIKE
Mailing Address - Street 2:
Mailing Address - City:SODDY DAISY
Mailing Address - State:TN
Mailing Address - Zip Code:37379-4750
Mailing Address - Country:US
Mailing Address - Phone:423-778-8500
Mailing Address - Fax:423-778-8501
Practice Address - Street 1:9448 DAYTON PIKE
Practice Address - Street 2:
Practice Address - City:SODDY DAISY
Practice Address - State:TN
Practice Address - Zip Code:37379-4750
Practice Address - Country:US
Practice Address - Phone:423-778-8500
Practice Address - Fax:423-778-8501
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN31316207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3852439Medicaid
TN3852439Medicaid
TN3852439Medicare PIN