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Individual

DR. THOMAS G JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5115 FONTAINE BLVD, FOUNTAIN, CO 80817-1061
(719) 392-2000
(719) 392-6937
Mailing address
5115 FONTAINE BLVD, FOUNTAIN, CO 80817-1061
(719) 392-2000
(719) 392-6937

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27569
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01275692
CO
Enumeration date
03/22/2006
Last updated
08/09/2011
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