Individual
KYLE ROBERT JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 S 5TH ST, DOUGLAS, WY 82633-2434
(307) 358-2122
Mailing address
111 S 5TH ST, DOUGLAS, WY 82633-2434
(307) 358-2122
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
16983A
WY
Other
Enumeration date
03/21/2019
Last updated
06/24/2024
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