| Doctor Name: | MR. DOUGLAS W JOHNSON |
| NPI Number: | 1003816471 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 50-00-0344 |
| Business Practice Address: | 1 Elizabeth Pl 4th Floor Dayton, OH - 454081445 |
| Business Phone Number: | 9372217001 |
| Business Fax Number: | 9372245307 |
| Mailing Address: | 3995 Willow Run Dr, BEAVERCREEK |
| State: | OH |
| Postal Code: | 454301552 |
| Phone Number: | 9374297132 |
| Fax Number: | 9372245307 |
| NPI Enumeration Date: | 07/28/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 50-00-0344 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |