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Individual

DR. CASEY JOHNSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
401 9TH AVE NW, WATERTOWN, SD 57201-1548
(605) 882-2630
(605) 882-0447
Mailing address
PO BOX 170, WATERTOWN, SD 57201-0170
(605) 882-2630
(605) 882-0447

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
5000
NE
207X00000X
Orthopaedic Surgery Physician
51596
MN
207X00000X
Orthopaedic Surgery Physician
Primary
7724
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00925881
RAILROAD MEDICARE
SD
Enumeration date
05/07/2007
Last updated
06/24/2011
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