Provider Demographics
NPI:1982661559
Name:JONES, JULIE JOHNSON (DPM)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:JOHNSON
Last Name:JONES
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1457 W MORRIS BLVD
Mailing Address - Street 2:STE D
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-2828
Mailing Address - Country:US
Mailing Address - Phone:423-581-9070
Mailing Address - Fax:423-581-9303
Practice Address - Street 1:1457 W MORRIS BLVD
Practice Address - Street 2:STE. D
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-2828
Practice Address - Country:US
Practice Address - Phone:423-581-9070
Practice Address - Fax:423-581-9303
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPM 440213E00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3352198Medicaid
TN3132199OtherBLUE CROSS BLUE SHIELD
TN480027658OtherPALMETTO GBA
TNU41595Medicare UPIN
TN3352198Medicare ID - Type Unspecified
TN3132199OtherBLUE CROSS BLUE SHIELD