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Individual

DR. JUSTIN THEO JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
1661 HIGHWAY 99 N, STE 201, ASHLAND, OR 97520-8900
(541) 482-4924
(541) 488-1732
Mailing address
1661 HWY 99 N STE 201, ASHLAND, OR 97520-8900
(541) 482-4924
(541) 488-1732

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
DPOO440
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1336328624
NPI
OR
01
DP00440
STATE MEDICAL LICENSE NUMBER
OR
Enumeration date
11/02/2007
Last updated
01/27/2017
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