Provider Demographics
NPI:1609923648
Name:JOHNSON, ALAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:M
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 1:2170 ROCK RD
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORDTON
Mailing Address - State:NC
Mailing Address - Zip Code:28139-8259
Mailing Address - Country:US
Mailing Address - Phone:828-606-3685
Mailing Address - Fax:
Practice Address - Street 1:257 MCDOWELL ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2606
Practice Address - Country:US
Practice Address - Phone:828-258-1121
Practice Address - Fax:828-252-6114
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC61197208G00000X
NC32380208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8946046Medicaid
NC3770700OtherUNITED HEALTHCARE
SCSCD6285019OtherMEDICARE PIN
NC60009478OtherRAILROAD MEDICARE
SC611975Medicaid
NC46046OtherBCBS