Provider Demographics
NPI:1831158518
Name:JOHNSON, DARLYNE A (MD)
Entity type:Individual
Prefix:DR
First Name:DARLYNE
Middle Name:A
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:S WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-4533
Mailing Address - Country:US
Mailing Address - Phone:339-201-4120
Mailing Address - Fax:781-545-8117
Practice Address - Street 1:90 LIBBEY PARKWAY
Practice Address - Street 2:SUITE 105
Practice Address - City:S WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189
Practice Address - Country:US
Practice Address - Phone:339-201-4120
Practice Address - Fax:781-545-8117
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA73287207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0700742OtherUNITED HEALTH CARE
MA13479OtherHARVARD PILGRIM
MAJ10761OtherBLUE CROSS BLUE SHIELD
MA720310OtherTUFTS HEALTH PLAN
MA0700742OtherUNITED HEALTH CARE
MA720310OtherTUFTS HEALTH PLAN