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NPI Code Detail

MEDICARE: KAREN DIANE JOHNSON MD

MEDICARE: KAREN DIANE JOHNSON MD
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 PhysicianMD14151OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689674996
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAREN DIANE JOHNSON MD
Provider Business Mailing Address
First Line : 1275 WALLACE RD NW
Second Line :
City : SALEM
State : OR
Zip : 97304-3007
Country : US
Telephone Number : 503-371-3232
Fax Number : 503-375-2398
Provider Business Practice Location Address
First Line : 1275 WALLACE RD NW
Second Line :
City : SALEM
State : OR
Zip : 97304-3007
Country : US
Telephone Number : 503-371-3232
Fax Number : 503-375-2398
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 10/17/2007

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Directions to “ KAREN DIANE JOHNSON MD” Practice Location

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