Individual
DR. GABRIEL HAYDEN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1008 MINNEQUA AVE, PUEBLO, CO 81004-3733
(719) 584-7410
Mailing address
PO BOX 7693, LOVELAND, CO 80537-0693
(706) 632-7429
(970) 342-2093
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2018-00655
NC
2085R0202X
Diagnostic Radiology Physician
48004
CO
208D00000X
General Practice Physician
48004
CO
Other
Enumeration date
06/27/2008
Last updated
06/03/2020
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