| Organization Name: | DOUG JOHNSON MD PC |
| NPI Number: | 1184741837 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DOUGLAS JOHNSON (PHYSICIAN) |
| Mailing Address: | 36 Oak Street Buena Vista |
| State: | CO US |
| Postal Code: | 81211 |
| Phone Number: | 7193958632 |
| Fax Number: | 7193954971 |
| NPI Enumeration Date: | 03/26/2007 |
| NPI Last Update Date: | 01/29/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VG0400X |
| License Number: | 35510 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Gynecology |
| Taxonomy Definition: | |