Individual
MICHAEL PAUL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2845 SIENA HEIGHTS DR, HENDERSON, NV 89052-4153
(702) 617-1227
(702) 492-9574
Mailing address
PO BOX 15645, MEDICAL STAFF OFFICE, LAS VEGAS, NV 89114-5645
(702) 560-2900
(702) 560-2990
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1201
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104985696
—
NV
01
—
P01254908
RAILROAD MEDICARE
NV
Enumeration date
12/08/2006
Last updated
02/21/2014
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