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NPI Code Detail

MEDICARE: DR. JAYSON JOHNSON M.D.

MEDICARE: DR. JAYSON JOHNSON M.D.
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
1207X00000XOrthopaedic Surgery Physician2015021994MO
2207XS0106XOrthopaedic Hand Surgery PhysicianM15661ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12015021994OTHERMOMISSOURI DIVISION OF PROFESSIONAL REGISTRATION

General Provider Information

NPI Number : 1841673118
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAYSON JOHNSON M.D.
Provider Business Mailing Address
First Line : 901 N CURTIS RD STE 304
Second Line :
City : BOISE
State : ID
Zip : 83706-1341
Country : US
Telephone Number : 208-577-5342
Fax Number : 208-375-0597
Provider Business Practice Location Address
First Line : 901 N CURTIS RD STE 304
Second Line :
City : BOISE
State : ID
Zip : 83706-1341
Country : US
Telephone Number : 208-342-4263
Fax Number : 208-375-0597
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2015
Last Update Date : 06/11/2021

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Directions to “ DR. JAYSON JOHNSON M.D.” Practice Location

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