Individual
TIMOTHY J JOHANS
Active
Individual
TIMOTHY J JOHANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
M6183
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100000076910
REGENCE BLUESHIELD OF IDAHO
ID
05
—
1730101148
—
ID
01
—
194498
OMAP
OR
01
—
72371
BLUE CROSS OF IDAHO
ID
Enumeration date
07/24/2006
Last updated
06/13/2023
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