Individual
ADAM CRANDALL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2300 E 30TH ST BLDG D, STE 101, FARMINGTON, NM 87401-8990
(505) 327-1400
(505) 564-3202
Mailing address
2300 E 30TH ST BLDG D, STE 101, FARMINGTON, NM 87401-8990
(505) 327-1400
(505) 564-3202
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD2012-0310
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
98107071
—
NM
01
—
MD2012-0310
MEDICAL LICENSE
NM
Enumeration date
04/19/2007
Last updated
03/07/2023
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