Individual
DR. THOMAS DALE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1102 DAKOTA CT, NEVADA, IA 50201-7966
(515) 296-2041
Mailing address
1102 DAKOTA CT, NEVADA, IA 50201-7966
(515) 296-2041
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
27083
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0055798
—
IA
Enumeration date
10/20/2005
Last updated
08/07/2025
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