Doctor Name: | MR. MICHAEL RORY JOHNSTON |
NPI Number: | 1114037256 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | 0014697 |
Business Practice Address: | 1229 C Ave E Oskaloosa, IA - 525774246 |
Business Phone Number: | 6416723193 |
Business Fax Number: | |
Mailing Address: | 1229 C Ave E, OSKALOOSA |
State: | IA |
Postal Code: | 525774246 |
Phone Number: | 6416723193 |
Fax Number: | |
NPI Enumeration Date: | 08/30/2006 |
NPI Last Update Date: | 07/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | 0014697 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |