Individual
DR. GREGORY J JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2221 W ELM ST, RAWLINS, WY 82301-0460
(307) 324-2221
Mailing address
PO BOX 460, RAWLINS, WY 82301-0460
(307) 324-2221
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
3772A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102833200
—
WY
05
—
107205600
—
WY
01
—
1399310
UMWA
WY
01
—
185872500
GROUP FED WRK COMP
WY
Enumeration date
08/17/2006
Last updated
12/22/2011
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