Provider Demographics
NPI:1750517769
Name:JOHNSON, ROBERT FLOYD JR (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FLOYD
Last Name:JOHNSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:453 W 10TH AVE
Mailing Address - Street 2:246 ATWELL HALL
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43210-2205
Mailing Address - Country:US
Mailing Address - Phone:614-366-8726
Mailing Address - Fax:614-293-3757
Practice Address - Street 1:453 W 10TH AVE
Practice Address - Street 2:246 ATWELL HALL
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-2205
Practice Address - Country:US
Practice Address - Phone:614-366-8726
Practice Address - Fax:614-293-3757
Is Sole Proprietor?:No
Enumeration Date:2009-06-04
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301036480207RC0200X
OH35.094795207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIA74189Medicare UPIN
OHH010640Medicare PIN