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NPI Code Detail

MEDICARE: BETH JOHNSON D.O.

MEDICARE: BETH JOHNSON D.O.
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 PhysicianCDRH.0060222CO

General Provider Information

NPI Number : 1932563566
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETH JOHNSON D.O.
Provider Business Mailing Address
First Line : 2001 S SHIELDS ST STE F
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-1833
Country : US
Telephone Number : 970-239-9930
Fax Number : 970-287-8800
Provider Business Practice Location Address
First Line : 2001 S SHIELDS ST STE F
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-1833
Country : US
Telephone Number : 970-239-9930
Fax Number : 970-287-8800
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2016
Last Update Date : 05/02/2026

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