Provider Demographics
NPI:1134197452
Name:JOHNS, JANET F (MD)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:F
Last Name:JOHNS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8485 ALGOMA AVE NE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-9102
Mailing Address - Country:US
Mailing Address - Phone:616-863-6220
Mailing Address - Fax:616-863-6221
Practice Address - Street 1:1200 56TH ST SW
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49509-9704
Practice Address - Country:US
Practice Address - Phone:616-514-3803
Practice Address - Fax:616-243-1170
Is Sole Proprietor?:No
Enumeration Date:2006-03-11
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301039651208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI134594310Medicaid
MI193200000XOtherTAXONOMY CODE
MI11279536OtherCAQH
MIF49094Medicare UPIN