Healthcare Provider Details

I. General information

NPI: 1366618423
Provider Name (Legal Business Name): SHAWN DOUGLAS JOHNSTON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2008
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 ARABIAN DR
LAFAYETTE LA
70507-2559
US

IV. Provider business mailing address

109 E SAINT PETER ST
CARENCRO LA
70520-4008
US

V. Phone/Fax

Practice location:
  • Phone: 337-565-4200
  • Fax: 337-565-4200
Mailing address:
  • Phone: 337-565-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number1479
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: