Individual
DR. WESLEY J JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2699 N 17TH ST, COOS BAY, OR 97420-2194
(541) 266-3600
(541) 269-0708
Mailing address
2699 N 17TH ST, COOS BAY, OR 97420-2194
(541) 266-3635
(541) 269-0708
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
13268
NV
207X00000X
Orthopaedic Surgery Physician
26379
AZ
207XS0117X
Orthopaedic Surgery of the Spine Physician
13268
NV
207XS0117X
Orthopaedic Surgery of the Spine Physician
26379
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598758880
RAILROAD MEDICARE
—
05
—
317322
—
AZ
Enumeration date
08/23/2005
Last updated
09/28/2020
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