Individual
JEFFREY L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
777 BANNOCK ST, MC 0206, DENVER, CO 80204-4507
(303) 436-6559
Mailing address
777 BANNOCK ST, MC 0206, DENVER, CO 80204-4507
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
38408
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
67982778
—
CO
01
—
P00083365
RAILROAD MEDICARE
CO
Enumeration date
07/27/2006
Last updated
07/08/2007
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