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Contact Information

JEDIDIAH E JOHNSON, HS1, IDC
4688 HOMER SPIT RD
HOMER, AK99603-8001
 Phone: 360-567-8238
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Independent Duty Corpsman

1710I1002X
 

Technician, Other

247200000X 75 Slide Preparation Facility
Indicates primary specialty

NPI Profile & details for JEDIDIAH E JOHNSON · (Male)

NPI # 1114000130
Status Active
Credentials HS1, IDC
Entity Individual
Enumeration date 10/23/2006
Last updated 10/08/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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