Individual
BRIAN LEE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
709 N LINCOLN AVE, JEROME, ID 83338-1851
(208) 324-4301
Mailing address
PO BOX 587, TWIN FALLS, ID 83303-0587
(208) 814-7400
(208) 814-7491
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-9334
ID
Other
Enumeration date
10/18/2005
Last updated
12/20/2013
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