| Dr Jon Bradley Johnson, MD | |
|
2516 Broadmoor Blvd, Monroe, LA 71201-2988 | |
| (318) 387-9420 | |
| (318) 323-8216 |
| Full Name | Dr Jon Bradley Johnson |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 28 Years |
| Location | 2516 Broadmoor Blvd, Monroe, Louisiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629014626 | NPI | - | NPPES |
| 1698326 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 021605 (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Francis Medical Center | Monroe, LA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Baton Rouge Clinic, A Medical Corporation | 1254317001 | 266 |
| Entity Name | Baton Rouge Clinic, A Medical Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871546911 PECOS PAC ID: 1254317001 Enrollment ID: O20040624000911 |
| Entity Name | Affinity Health Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023291226 PECOS PAC ID: 9335226547 Enrollment ID: O20080411000088 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jon Bradley Johnson, MD 130 Desiard St, Suite 355, Monroe, LA 71201-7319 Ph: (318) 807-7875 | Dr Jon Bradley Johnson, MD 2516 Broadmoor Blvd, Monroe, LA 71201-2988 Ph: (318) 387-9420 |
Odell Joseph Dean Jr., M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 2516 Broadmoor Blvd, Monroe, LA 71201 Phone: 318-807-1390 Fax: 318-807-1394 | |
Robert L Humble, MD Urology Medicare: Medicare Enrolled Practice Location: 2516 Broadmoor Blvd, Monroe, LA 71201 Phone: 318-807-1390 Fax: 318-807-1394 | |
Dr. Arthur E Liles, MD Urology Medicare: Medicare Enrolled Practice Location: 2516 Broadmoor Blvd, Monroe, LA 71201 Phone: 318-387-9420 Fax: 318-323-8216 | |
Dr. Don F Marx, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 3510 Magnolia Cv, Suite 170, Monroe, LA 71203 Phone: 318-387-9774 Fax: 318-322-7306 |