Individual
THEODORE STANLEY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
DEPT. # 1029, DENVER, CO 80263-0001
(352) 867-8898
(352) 732-6282
Mailing address
DEPT # 1029, DENVER, CO 80263-0001
(352) 867-8898
(352) 732-6282
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME30185
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01301852
—
CO
01
—
A6528
ANTHEM/BLUE CROSS
CO
01
—
D4548
RAILROAD MEDICARE
CO
Enumeration date
05/15/2006
Last updated
08/24/2010
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