Individual
PHILIP SCOTT JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1024 S LEMAY AVE, FORT COLLINS, CO 80524-3929
(303) 306-7783
(303) 306-7753
Mailing address
PO BOX 912215, DENVER, CO 80291-2215
(303) 306-7783
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
29469
CO
207P00000X
Emergency Medicine Physician
Primary
29469
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01294693
—
CO
05
—
104146100
—
WY
01
—
930025960
RAILROAD MEDICARE
CO
01
—
S5008
BCBS
—
Enumeration date
07/07/2006
Last updated
02/25/2014
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