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NPI Code Detail

MEDICARE: DAVID P JOHNSON MD

MEDICARE:   DAVID P JOHNSON  MD
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
1207V00000XObstetrics & Gynecology PhysicianMD 15167OR

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1R157975OTHERORMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558342212
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID P JOHNSON MD
Provider Business Mailing Address
First Line : 7650 SW BEVELAND RD
Second Line : SUITE200
City : PORTLAND
State : OR
Zip : 97223-8692
Country : US
Telephone Number : 503-538-2698
Fax Number : 503-554-9328
Provider Business Practice Location Address
First Line : 1003 PROVIDENCE DR
Second Line : SUITE 340
City : NEWBERG
State : OR
Zip : 97132-7485
Country : US
Telephone Number : 503-538-2698
Fax Number : 503-554-9328
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2005
Last Update Date : 06/17/2016

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Directions to “ DAVID P JOHNSON MD” Practice Location

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