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General NPI Number Information
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NPI Number | 1427337849
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Entity Type | Organization
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Legal Business Name | DARRYL C JOHNSON DO PC
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Dates
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Enumeration Date | 08/16/2011
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Last Update Date | 08/29/2012
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Provider Practice Location Address
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Address Line | 1912 MIDDLE RD SUITE 200
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City | BETTENDORF
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State | IA
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Zip | 52722-7600
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Country | US
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Telephone | 563-355-7770
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Fax | 563-355-7997
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Provider Business Mailing Address
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Address Line | 1912 MIDDLE RD SUITE 200
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City | BETTENDORF
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State | IA
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Zip | 52722-7600
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Country | US
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Telephone | 563-355-7770
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Fax | 563-355-7997
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DARRYL C JOHNSON
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Credential |
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Telephone | 563-355-7770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 02790
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License Number State | IA
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