Provider Demographics
NPI:1912376682
Name:JOHNSON, JAMES ALAN (RT(R) (ARRT))
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ALAN
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:RT(R) (ARRT)
Other - Prefix:MR
Other - First Name:ALAN
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RT(R) (ARRT)
Mailing Address - Street 1:540 RED VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:REMLAP
Mailing Address - State:AL
Mailing Address - Zip Code:35133-4536
Mailing Address - Country:US
Mailing Address - Phone:205-936-3836
Mailing Address - Fax:
Practice Address - Street 1:50 MEDICAL PARK DR E
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3401
Practice Address - Country:US
Practice Address - Phone:205-838-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4069112471C3402X, 2471C1101X
ALAL05259146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C1101XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistCardiovascular-Interventional Technology
No2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant