Individual
DAVID A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2600 MARBLE AVE NE, ALBUQUERQUE, ALBUQUERQUE, NM 87106-2058
(505) 272-1221
(505) 272-9843
Mailing address
2600 MARBLE AVE NE, ALBUQUERQUE, ALBUQUERQUE, NM 87106-2058
(505) 272-1221
(505) 272-9843
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45172871
—
NM
Enumeration date
05/14/2013
Last updated
02/16/2015
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