Johnson, Paul Jennings

Johnson, Paul Jennings is an individual health care provider with primary practice located at 929 Sw Simpson Ave Suite 300, Bend OR 97702-3599. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Johnson, Paul Jennings can be contacted via phone (541) 389-7741.

Contact Information

Primary practice address
929 Sw Simpson Ave Suite 300 Bend OR 97702-3599
Fax: (541) 278-8376
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD13627 Oregon

Profile Details

NPI number 1699774877
LBN Legal business name Johnson, Paul Jennings
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2005
Last updated Mar 29th, 2016 - about 9 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 1699774877 NPPES
Oregon MEDICAID 284323

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