Individual
WAYNE WILLIAM JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
799 E HAMPDEN AVE, #400, ENGLEWOOD, CO 80113-2700
(303) 789-2663
(303) 788-4871
Mailing address
4900 S MONACO ST, #210, DENVER, CO 80237-3486
(303) 789-2663
(303) 788-4871
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
243
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201076740A
—
KS
05
—
82603219
—
CO
Enumeration date
03/05/2013
Last updated
01/13/2022
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