Individual
KURT SAMUEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 E UNIVERSITY AVE, LARAMIE, WY 82071-2000
(307) 766-5071
(307) 761-9319
Mailing address
1000 E UNIVERSITY AVE, LARAMIE, WY 82071-2000
(307) 766-5071
(307) 766-2112
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6832A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118192100
—
WY
Enumeration date
12/22/2005
Last updated
09/13/2023
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