Provider Demographics
NPI:1316206337
Name:JOHNSON, MINDY SMITH (MD)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:SMITH
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 PATTERSON ST STE 400
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1575
Mailing Address - Country:US
Mailing Address - Phone:615-342-5900
Mailing Address - Fax:
Practice Address - Street 1:2400 PATTERSON ST STE 400
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1575
Practice Address - Country:US
Practice Address - Phone:615-342-5900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-10
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000052129207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine