Individual
TYLER W JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-5200
(208) 625-5201
Mailing address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-4000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4971842
ID
208600000X
Surgery Physician
LL82173
SC
Other
Enumeration date
05/29/2018
Last updated
12/18/2025
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