Provider Demographics
NPI:1043223977
Name:JOHNSON, ERNEST F III (MD)
Entity type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:F
Last Name:JOHNSON
Suffix:III
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 37938
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28237-7938
Mailing Address - Country:US
Mailing Address - Phone:704-332-0366
Mailing Address - Fax:704-971-0035
Practice Address - Street 1:433 COPPERFIELD BLVD NE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2405
Practice Address - Country:US
Practice Address - Phone:704-786-7770
Practice Address - Fax:704-971-0035
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-01144207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7710564OtherCIGNA
NC14057OtherBCBS
NC5902844Medicaid
807116OtherPARTNERS MEDICARE
P00326285OtherRR MEDICARE
807116OtherPARTNERS MEDICARE
NCNC9893AMedicare PIN