Provider Demographics
NPI:1205068525
Name:JOHNSON, ANKREHAH TRIMBLE (DO)
Entity type:Individual
Prefix:DR
First Name:ANKREHAH
Middle Name:TRIMBLE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 MEDICAL PARK DR E
Mailing Address - Street 2:SUITE 154
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3400
Mailing Address - Country:US
Mailing Address - Phone:205-202-5650
Mailing Address - Fax:205-202-5655
Practice Address - Street 1:48 MEDICAL PARK DR E
Practice Address - Street 2:SUITE 154
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3400
Practice Address - Country:US
Practice Address - Phone:205-202-5650
Practice Address - Fax:205-202-5655
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO 1167207Q00000X, 207QA0000X, 207QA0505X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine