Organization
DOUG JOHNSON MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS JOHNSON M D (PHYSICIAN)
(719) 395-8632
Entity
Organization
Contact information
Practice address
36 OAK STREET, BUENA VISTA, CO 81211
(719) 395-8632
(719) 395-4971
Mailing address
PO BOX 3129, BUENA VISTA, CO 81211-3129
(719) 395-8632
(719) 395-4971
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
35510
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04016812
—
CO
Enumeration date
03/26/2007
Last updated
01/29/2009
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