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Individual

DR. ADAM JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
625 E BROADWAY AVE, JACKSON, WY 83001-8642
(307) 739-7250
(307) 739-7249
Mailing address
PO BOX 428, JACKSON, WY 83001-0428
(307) 739-7250
(307) 739-7249

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
6447817-1205
UT
207P00000X
Emergency Medicine Physician
Primary
7834A
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
139580000
WY
Enumeration date
01/22/2007
Last updated
02/10/2021
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