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General NPI Number Information
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NPI Number | 1679626204
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Entity Type | Organization
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Legal Business Name | JOHNNY E JOHNSON JR M D P C
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 08/15/2016
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Provider Practice Location Address
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Address Line | 4545 E 9TH AVE SUITE 300
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City | DENVER
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State | CO
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Zip | 80220-3901
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Country | US
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Telephone | 303-261-3825
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Fax | 303-261-3827
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Provider Business Mailing Address
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Address Line | 4545 E 9TH AVE SUITE 130
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City | DENVER
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State | CO
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Zip | 80220-3901
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Country | US
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Telephone | 303-261-3825
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Fax | 303-261-3827
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHNNY EMANUEL JOHNSON JR.
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Credential | MD
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Telephone | 303-261-3825
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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 | 22809
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License Number State | CO
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