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Individual

MR. JEFFREY DON JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
310 S PECOS ST, COLEMAN, TX 76834-4159
(325) 793-2000
Mailing address
PO BOX 1827, BROWNWOOD, TX 76804-1827
(325) 641-2655
(325) 641-0992

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
595335
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00C44S
BCBS GROUP #
TX
05
088844804
TX
05
170450401
TX
01
84214U
BCBS IND. PROV. #
TX
Enumeration date
06/16/2005
Last updated
02/20/2009
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