Johnson, Dale S.
Johnson, Dale S. is an sole proprietor health care provider with primary practice located at 1319 Vivian St , Longmont CO 80501-3216. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Johnson, Dale S. can be contacted via phone (303) 772-3611.Contact Information
Primary practice address
1319 Vivian St
Longmont CO 80501-3216
Phone: (303) 772-3611
Fax: (303) 772-3609
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 18358 | Colorado |
Profile Details
| NPI number | 1235189143 |
|---|---|
| LBN Legal business name | Johnson, Dale S. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 11th, 2006 |
| Last updated | Jun 24th, 2010 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235189143 | NPPES |
| Colorado | MEDICAID | 01183581 |
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