| David a Johnson MD Inc | |
|
915 Mountain St Carson City NV 89703-3819 | |
| (775) 515-0022 | |
| (775) 515-0044 |
| Full Name | David a Johnson MD Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 915 Mountain St, Carson City, Nevada |
| Authorized Official Name and Position | David a Johnson (PHYSICIAN/OWNER) |
| Authorized Official Contact | 7755150022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David a Johnson MD Inc 915 Mountain St Carson City NV 89703-3819 Ph: (775) 515-0022 | David a Johnson MD Inc 915 Mountain St Carson City NV 89703-3819 Ph: (775) 515-0022 |
| NPI Number | 1487391264 |
|---|---|
| Provider Enumeration Date | 05/13/2022 |
| Last Update Date | 05/13/2022 |
| Certification Date | 05/13/2022 |
| Medicare PECOS PAC ID | 2062895485 |
|---|---|
| Medicare Enrollment ID | O20220818000310 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487391264 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | David a Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568596229 PECOS PAC ID: 8527147917 Enrollment ID: I20080904000374 |
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