Healthcare Provider Details

I. General information

NPI: 1366865149
Provider Name (Legal Business Name): AUSTIN JOHNSTON D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2014
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 VILLAGE LOOP RD
KALISPELL MT
59901-2793
US

IV. Provider business mailing address

46 VILLAGE LOOP RD
KALISPELL MT
59901-2793
US

V. Phone/Fax

Practice location:
  • Phone: 406-607-6050
  • Fax: 877-418-8011
Mailing address:
  • Phone: 406-607-6050
  • Fax: 877-418-8011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number58011
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: