Individual
JACOB T JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1005 YELLOWSTONE STREET, FORT PIERRE, SD 57532
(605) 280-4481
Mailing address
1820 RAND RD, RAPID CITY, SD 57702-9393
(605) 280-4481
Taxonomy
Speciality
Code
Description
License number
State
1835P1400X
Pain Management Pharmacist
22ESTC0839
SD
1835P1400X
Pain Management Pharmacist
22ESTC5017
SD
1835P1400X
Pain Management Pharmacist
22ESTC7355
SD
1835P1400X
Pain Management Pharmacist
Primary
22ESTC8676
SD
1835P1400X
Pain Management Pharmacist
25ESTC1701
SD
Other
Enumeration date
06/29/2026
Last updated
06/29/2026
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