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General NPI Number Information
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NPI Number | 1295899672
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Entity Type | Individual
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Provider Name | JEFFREY D JOHNSON DPM
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Gender | Male
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 237 MAIN ST STE 3
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City | MEXICO
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State | ME
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Zip | 04257-2603
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Country | US
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Telephone | 207-200-8814
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Fax | 207-558-8980
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Provider Business Mailing Address
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Address Line | 65 LINCOLN AVE, SUITE 1
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City | RUMFORD
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State | ME
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Zip | 04276-2104
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Country | US
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Telephone | 207-200-8814
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Fax | 207-558-8980
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | POD1034
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License Number State | ME
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