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NPI Code Detail

MEDICARE: TIMOTHY JOHNSON

MEDICARE:   TIMOTHY  JOHNSON
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
1237700000XHearing Instrument Specialist

General Provider Information

NPI Number : 1487999033
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY JOHNSON
Provider Business Mailing Address
First Line : 920 N TELSHOR BLVD STE A
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-8279
Country : US
Telephone Number : 575-526-3277
Fax Number : 575-522-0026
Provider Business Practice Location Address
First Line : 920 N TELSHOR BLVD STE A
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-8279
Country : US
Telephone Number : 575-526-3277
Fax Number : 575-522-0026
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2012
Last Update Date : 12/10/2012

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Directions to “ TIMOTHY JOHNSON ” Practice Location

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