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Individual

DR. GEORGE DAVID JOHNSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
825 BENNETT AVE, MEDFORD, OR 97504-6715
(541) 779-5228
(541) 772-1533
Mailing address
825 BENNETT AVE, MEDFORD, OR 97504-6715
(541) 779-5228
(541) 772-1533

Taxonomy

Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
20A8812
CA
208VP0014X
Interventional Pain Medicine Physician
Primary
DO24988
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
275335
OR
Enumeration date
04/06/2006
Last updated
10/19/2012
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