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General NPI Number Information
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NPI Number | 1215926985
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Entity Type | Individual
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Provider Name | JAMES L JOHNSON II M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 10/21/2020
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Provider Practice Location Address
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Address Line | 125 W YELLOWSTONE AVE
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City | CODY
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State | WY
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Zip | 82414-8723
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Country | US
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Telephone | 307-527-7129
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Fax | 307-587-7394
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Provider Business Mailing Address
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Address Line | 2820 CENTRAL AVE STE A
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City | BILLINGS
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State | MT
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Zip | 59102-8624
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Country | US
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Telephone | 406-896-2478
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Fax | 406-896-2491
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 6172A
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License Number State | WY
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