MEDICARE: DR. DAVID C. JOHNSON, P.C.

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	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

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

General Provider Information

NPI Number	:	1972773315
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. DAVID C. JOHNSON, P.C.

Provider Business Mailing Address
First Line	:	1313 PLEASANT DR
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50265-2327
Country	:	US
Telephone Number	:	515-223-1092
Fax Number	:

Provider Business Practice Location Address
First Line	:	1313 PLEASANT DR
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50265-2327
Country	:	US
Telephone Number	:	515-223-1092
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DAVID C JOHNSON
Credential	:
Telephone Number	:	515-223-1092

Provider Enumeration Date	:	02/29/2008
Last Update Date	:	05/19/2010

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