Provider Demographics
NPI:1861684953
Name:JOHNS, TIA M (IDC)
Entity type:Individual
Prefix:MRS
First Name:TIA
Middle Name:M
Last Name:JOHNS
Suffix:
Gender:F
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:US NAVAL HOSPITAL NAPLES
Mailing Address - Street 2:PSC 827 BOX 217
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09617
Mailing Address - Country:IT
Mailing Address - Phone:01139081-811-6274
Mailing Address - Fax:01139081-811-6307
Practice Address - Street 1:US NAVAL HOSPITAL NAPLES
Practice Address - Street 2:PSC 827 BOX 217
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09617
Practice Address - Country:IT
Practice Address - Phone:01139081-811-6274
Practice Address - Fax:01139081-811-6307
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman