Individual
DR. TERESA KAY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
298 1ST ST, IDAHO FALLS, ID 83401-3966
(208) 529-2544
(208) 529-3771
Mailing address
298 1ST ST, IDAHO FALLS, ID 83401-3966
(208) 529-2544
(208) 529-3771
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-8742
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806599100
—
ID
Enumeration date
08/04/2006
Last updated
10/22/2024
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