Provider Demographics
NPI:1346322948
Name:JOHNSON, LARRY TURNNER (MD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:TURNNER
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 BEAVER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75137-3729
Mailing Address - Country:US
Mailing Address - Phone:972-780-8946
Mailing Address - Fax:
Practice Address - Street 1:2301 S HAMPTON RD
Practice Address - Street 2:800
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75224-1650
Practice Address - Country:US
Practice Address - Phone:214-333-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG6311207XX0005X, 207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Not Answered207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma