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Contact Information

DAVID JOHNSON, M.D., P. A.
775 POLE LINE RD W
SUITE 213
TWIN FALLS, ID83301-5814
 Phone: 208-814-8475
 Fax: 208-734-4177
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vascular Surgery

2086S0129X 76 Physician/Peripheral Vascular Disease
Indicates primary specialty

NPI Profile & details for DAVID JOHNSON, M.D., P. A.

NPI # 1467499418
LBN Legal business name DAVID JOHNSON, M.D., P. A.
Authorized official DAVID JOHNSON - (PHYSICIAN)
Entity Organization
Organization subpart 1 No
Enumeration date 05/31/2006
Last updated 03/09/2013 - About 13 years ago
Identifiers
ID License # M9086
ID Medicaid 003760400
ID Other 020051471 RR MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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