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General NPI Number Information
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NPI Number | 1073044343
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Entity Type | Individual
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Provider Name | JASON DOUGLAS JOHNSON
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Gender | Male
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Dates
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Enumeration Date | 03/27/2017
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Last Update Date | 11/16/2025
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Provider Practice Location Address
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Address Line | 63351 US HIGHWAY 93
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City | RONAN
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State | MT
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Zip | 59864-2702
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Country | US
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Telephone | 406-676-5680
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Fax | 406-676-5690
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Provider Business Mailing Address
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Address Line | PO BOX 31001
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City | PASADENA
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State | CA
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Zip | 91110-4110
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Country | US
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Telephone | 406-676-5680
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Fax | 406-676-5690
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 6679
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MED-PHYS-LIC-132637
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License Number State | MT
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