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NPI Code Detail

MEDICARE: CHARLES JOHNSTON M.D.

MEDICARE: CHARLES JOHNSTON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician10606NV

General Provider Information

NPI Number : 1588655526
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES JOHNSTON M.D.
Provider Business Mailing Address
First Line : PO BOX 50864
Second Line :
City : HENDERSON
State : NV
Zip : 89016-0864
Country : US
Telephone Number : 702-458-5099
Fax Number : 702-458-5199
Provider Business Practice Location Address
First Line : 8280 W WARM SPRINGS RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-3612
Country : US
Telephone Number : 702-458-5099
Fax Number : 702-458-5199
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2005
Last Update Date : 07/08/2007

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