Provider Demographics
NPI:1700875176
Name:JOHNSON, ANTHONY EUGENE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:EUGENE
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:3851 ROGER BROOKE DR
Mailing Address - Street 2:BAMC ORTHOPAEDIC SURGERY
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4501
Mailing Address - Country:US
Mailing Address - Phone:210-916-5666
Mailing Address - Fax:210-916-0559
Practice Address - Street 1:3851 ROGER BROOKE DR
Practice Address - Street 2:BAMC ORTHOPAEDIC SURGERY
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4501
Practice Address - Country:US
Practice Address - Phone:210-916-5666
Practice Address - Fax:210-916-0559
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2017-09-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA70680207XX0005X, 207X00000X
TXQ2309207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine