Individual
DR. JOHN A. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3165 E GREENHURST RD, NAMPA, ID 83686
(208) 463-7330
Mailing address
190 E BANNOCK ST, BOISE, ID 83712
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M10563
ID
207QS0010X
Sports Medicine (Family Medicine) Physician
M-10563
ID
Other
Enumeration date
01/19/2006
Last updated
09/18/2012
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