Provider Demographics
NPI:1376194092
Name:JOHNSON, DONALD WAYNE JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:WAYNE
Last Name:JOHNSON
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209-6511
Mailing Address - Country:US
Mailing Address - Phone:904-244-4157
Mailing Address - Fax:
Practice Address - Street 1:UF HEALTH JACKSONVILLE
Practice Address - Street 2:655 WEST 8TH STREET
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209
Practice Address - Country:US
Practice Address - Phone:904-244-4157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-24
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL424251835C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835C0205XPharmacy Service ProvidersPharmacistCritical CareGroup - Single Specialty