Individual
MR. SCOTT ROGER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
51600 HUNTINGTON RD, LA PINE, OR 97739-8887
(541) 536-3435
Mailing address
PO BOX 3300, LA PINE, OR 97739-3300
(541) 536-3435
(541) 536-8047
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
00826
OR
Other
Enumeration date
01/15/2008
Last updated
09/08/2022
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