Dr. Robert W. Johnson, L.L.C. – Dentist

Key facts

NPI: 1427369891
Entity type: Organization (NPI type 2)
Primary specialty: Dentist 122300000X
Legal business name: DR. ROBERT W. JOHNSON, L.L.C.
Practice address: 515 W Waddil St
Post Office Box 307
Marksville, LA 71351-2648
Phone: (318) 253-5141
Fax: (318) 240-8735
NPI assigned: Jun 30, 2010
Organization subpart: No

Authorized official

Name: Robert Allen Johnson
Title: Director
Phone: (318) 253-0935

National Provider Directory

Locations

515 W Waddil St
Marksville, LA 71351
Phone (318) 253-5141

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dentist Group: 193200000X MULTI-SPECIALTY GROUP	122300000X			Yes

Addresses

Primary practice location

515 W Waddil St
Post Office Box 307
Marksville, LA 71351-2648

Mailing address

515 W Waddil St
Post Office Box 307
Marksville, LA 71351-2648
Phone (318) 253-5141

Other identifiers

Identifier	Type	State	Issuer
1823601	Medicaid	LA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 30, 2010.

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277856000000",
    "number": "1427369891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W WADDIL ST",
            "address_2": "POST OFFICE BOX 307",
            "city": "MARKSVILLE",
            "state": "LA",
            "postal_code": "713512648",
            "telephone_number": "318-253-5141",
            "fax_number": "318-240-8735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W WADDIL ST",
            "address_2": "POST OFFICE BOX 307",
            "city": "MARKSVILLE",
            "state": "LA",
            "postal_code": "713512648",
            "telephone_number": "318-253-5141",
            "fax_number": "318-240-8735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. ROBERT W. JOHNSON, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-30",
        "last_updated": "2010-06-30",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "318-253-0935"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1823601",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marksville, LA

All providers in Marksville, LA · Dentist in Louisiana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2010. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.