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NPI Code Detail

MEDICARE: ROBERT L JOHNSON DO

MEDICARE: ROBERT L JOHNSON DO
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
12084P0800XPsychiatry PhysicianOP00001376WA

General Provider Information

NPI Number : 1366410425
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT L JOHNSON DO
Provider Business Mailing Address
First Line : 77 WAINWRIGHT DR
Second Line :
City : WALLA WALLA
State : WA
Zip : 99362-3975
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 77 WAINWRIGHT DR
Second Line :
City : WALLA WALLA
State : WA
Zip : 99362-3975
Country : US
Telephone Number : 509-525-5200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 07/16/2007

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Directions to “ ROBERT L JOHNSON DO” Practice Location

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