Provider Demographics
NPI:1407442536
Name:JOHNSON, JAMES HARRY JR
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:HARRY
Last Name:JOHNSON
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 KANSAS DR
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-4408
Mailing Address - Country:US
Mailing Address - Phone:937-532-6578
Mailing Address - Fax:
Practice Address - Street 1:160 KANSAS DR
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-4408
Practice Address - Country:US
Practice Address - Phone:937-532-6578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-13
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No347C00000XTransportation ServicesPrivate Vehicle