MEDICARE: JOHNSTON YEE FAMILY MEDICINE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1154496214
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHNSTON YEE FAMILY MEDICINE PC

Provider Business Mailing Address
First Line	:	8285 W ARBY AVE STE 190
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2228
Country	:	US
Telephone Number	:	702-458-5099
Fax Number	:	702-458-5199

Provider Business Practice Location Address
First Line	:	8285 W ARBY AVE STE 190
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2228
Country	:	US
Telephone Number	:	702-458-5099
Fax Number	:	702-458-5199

Authorized Official
Title or Position	:	OWNER
Name	:	CHARLES JOHNSTON
Credential	:	MD
Telephone Number	:	702-458-5099

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	08/27/2007

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