Dr. Dwayne Edward Johnson
M.D. | Pediatrics | Male
Dr. Dwayne Edward Johnson, M.D. is a Elkhart, Indiana based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Dr. Dwayne Edward Johnson is
236 Simpson Ave, Elkhart, Indiana - 46516-4666. He can be contacted on phone at
574-584-7373 and fax number 574-293-3744.
Dr. Dwayne Edward Johnson is a sole proprietor of his business.
NPI number (Unique professional ID) for Dr. Dwayne Edward Johnson is
1841379187 which was assigned by NPPES on 06 Nov, 2006 and it was last updated on 08 Mar, 2017.
Dr. Dwayne Edward Johnson license number is
01073977A for Pediatrics (208000000X) in Indiana.
Dr. Dwayne Edward Johnson is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Dr. Dwayne Edward Johnson basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
|---|
| Provider Name : | Dr. Dwayne Edward Johnson |
|---|
| Credential : | M.D. |
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| Gender : | Male |
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| Sole Proprietor : | Yes |
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Business Address:
Dr. Dwayne Edward Johnson address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 236 Simpson Ave
Elkhart, IN, 46516-4666
United States |
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| Phone Number : | 574-584-7373 |
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| Fax Number : | 574-293-3744 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1841379187 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 06 Nov, 2006 |
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| Last Updated On : | 08 Mar, 2017 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Dwayne Edward Johnson are as mentioned. Primary taxonomy code for Dr. Dwayne Edward Johnson, M.D. is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | No | 28666 | KY |
| 208000000X | Pediatrics | Yes | 01073977A | IN |
Legacy Identifiers:
Other legacy medical identifiers of Dr. Dwayne Edward Johnson such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 2133380 | Other | | AETNA |
| 611336483 | Other | | 4MOST HEALTH NETWORK |
| 2435769000 | Other | | PASSPORT ADVANTAGE |
| 000000052119 | Other | | ANTHEM |
| 611336483 | Other | | HUMANA HEALTH PLAN, INC. |
| 611336483 | Other | | MAIL HANDLERS BENEFIT PLA |
| 87043 | Other | | FIRST HEALTH NETWORK |
| 200287610B | MEDICAID | IN | |
| 1087687 | Other | | PASSPORT HEALTH PLAN |
| 642886669 | MEDICAID | KY | |
| 611336483 | Other | | UNITED HEALTHCARE |
| 611336483 | Other | | COMMONWEALTH HEALTH ALLIA |
| 611336483 | Other | | PPONEXT |
| 611336483 | Other | | PREFERRED HEALTH PLAN |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 148 W Hively Ave, Suite 1
Elkhart, IN, 46517-2191
United States |
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| Phone Number : | 574-350-2500 |
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| Fax Number : | 574-350-2598 |
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Business Location:
Patients can refer following map for directions to
Dr. Dwayne Edward Johnson practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.