Individual
DR. STEPHEN C. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4021 AVENUE B, SCOTTSBLUFF, NE 69361-4602
(303) 761-9190
(720) 874-4462
Mailing address
10700 E GEDDES AVE, SUITE 200, ENGLEWOOD, CO 80112-3800
(303) 761-9190
(720) 874-4462
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
18166
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025709000
—
NE
05
—
1235126780
—
WY
05
—
1235126780/7726960
—
SD
01
—
P00720335
RR MCR NE
NE
Enumeration date
09/30/2005
Last updated
04/07/2017
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