Individual
PAUL JENNINGS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
929 SW SIMPSON AVE, SUITE 300, BEND, OR 97702-3599
(541) 389-7741
(541) 278-8376
Mailing address
PO BOX 670, BEND, OR 97709-0670
(541) 389-7741
(541) 278-8376
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD13627
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
284323
—
OR
Enumeration date
07/19/2005
Last updated
03/29/2016
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