Johnson, Jack
Johnson, Jack is an individual health care provider with primary practice located at 455 Sherman St Ste 510, Denver CO 80203-4400. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Johnson, Jack can be contacted via phone (303) 377-6825.Contact Information
Primary practice address
455 Sherman St Ste 510
Denver CO 80203-4400
Phone: (303) 377-6825
Fax: (303) 780-0787
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 37891 | Colorado |
Profile Details
| NPI number | 1356316996 |
|---|---|
| LBN Legal business name | Johnson, Jack |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 17th, 2006 |
| Last updated | Apr 18th, 2013 - about 11 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 | 1356316996 | NPPES |
| Colorado | MEDICAID | 51687275 |
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