Provider Demographics
NPI:1831430768
Name:JOHNSON, RONALD HARVEY (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:HARVEY
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:411 PARK HILL DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3376
Mailing Address - Country:US
Mailing Address - Phone:540-372-6811
Mailing Address - Fax:540-372-7099
Practice Address - Street 1:411 PARK HILL DR
Practice Address - Street 2:SUITE A
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3376
Practice Address - Country:US
Practice Address - Phone:540-372-6811
Practice Address - Fax:540-372-7099
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101053948207RB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity Medicine