MEDICARE: DR. HENRY M JOHNSTON III 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
1	207P00000X	Emergency Medicine Physician	DR.0025592	CO

General Provider Information

NPI Number	:	1770630121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HENRY M JOHNSTON III M.D.

Provider Business Mailing Address
First Line	:	15065 W 52ND AVE
Second Line	:
City	:	GOLDEN
State	:	CO
Zip	:	80403-1225
Country	:	US
Telephone Number	:	303-885-9759
Fax Number	:

Provider Business Practice Location Address
First Line	:	15065 W 52ND AVE
Second Line	:
City	:	GOLDEN
State	:	CO
Zip	:	80403-1225
Country	:	US
Telephone Number	:	303-885-9759
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	02/10/2026

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