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Individual
GARY M JOHNSON
Active
Individual
GARY M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA946
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001516008
—
NV
05
—
003116008
—
NV
Enumeration date
10/03/2006
Last updated
03/25/2015
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