Provider Demographics
NPI:1447461009
Name:JOHNSON, ERIK ROBERT (MD)
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:ROBERT
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TRIPLER ARMY MEDICAL CENTER
Mailing Address - Street 2:1 JARRETT WHITE RD
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96859
Mailing Address - Country:US
Mailing Address - Phone:808-633-6338
Mailing Address - Fax:
Practice Address - Street 1:1 JARRETT WHITE RD
Practice Address - Street 2:
Practice Address - City:TRIPLER ARMY MEDICAL CENTER
Practice Address - State:HI
Practice Address - Zip Code:96859-5001
Practice Address - Country:US
Practice Address - Phone:808-433-6338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7680399-12052080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology