Johnson, Bradley Todd

Johnson, Bradley Todd is an individual health care provider with primary practice located at 1010 Three Springs Blvd , Durango CO 81301-8296. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Johnson, Bradley Todd can be contacted via phone (303) 306-7783.

Contact Information

Primary practice address
1010 Three Springs Blvd Durango CO 81301-8296
Phone: (303) 306-7783
Fax: (303) 306-7753
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 956 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 3202 Colorado

Profile Details

NPI number 1710167655
LBN Legal business name Johnson, Bradley Todd
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2007
Last updated Nov 3rd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710167655 NPPES
Colorado MEDICAID 48483885
Colorado MEDICAID 35323884

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