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General NPI Number Information
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NPI Number | 1922369024
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Entity Type | Individual
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Provider Name | OREN WAYNE JOHNSON MD
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Gender | Male
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Dates
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Enumeration Date | 06/05/2012
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 759 CHESTNUT ST
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City | SPRINGFIELD
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State | MA
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Zip | 01107-1619
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Country | US
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Telephone | 413-794-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 1350 MAIN ST STE 1007
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City | SPRINGFIELD
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State | MA
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Zip | 01103-1664
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Country | US
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Telephone | 908-400-0120
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Fax |
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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 | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | D0101839
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | D0101839
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | 262589
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License Number State | MA
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