| Doctor Name: | MR. STEPHEN JOHNSTON |
| NPI Number: | 1629337753 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | PA-3428 |
| Business Practice Address: | 356110 E 930 Rd Stroud, OK - 740795184 |
| Business Phone Number: | 9189689531 |
| Business Fax Number: | 9189680113 |
| Mailing Address: | 19632 Stratmore Way, EDMOND |
| State: | OK |
| Postal Code: | 730122205 |
| Phone Number: | 9706726952 |
| Fax Number: | |
| NPI Enumeration Date: | 05/09/2012 |
| NPI Last Update Date: | 05/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA-3428 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |