Johnson, Stanley Mark
Johnson, Stanley Mark is an individual health care provider with primary practice located at 1400 E Boulder St , Colorado Springs CO 80909-5533. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Johnson, Stanley Mark can be contacted via phone (719) 365-5000.Contact Information
Primary practice address
1400 E Boulder St
Colorado Springs CO 80909-5533
Phone: (719) 365-5000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 39748 | Colorado |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 04-13971 | Kansas |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 20189 | Minnesota |
Profile Details
| NPI number | 1861463648 |
|---|---|
| LBN Legal business name | Johnson, Stanley Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 30th, 2006 |
| Last updated | Mar 7th, 2023 - about 2 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 | 1861463648 | NPPES |
| Minnesota | Other | 20189 | MEDICAL LICENSE |
| Minnesota | Other | O4-13971 | MEDICAL LICENSE |
| Minnesota | Other | 39748 | MEDICAL LICENSE |
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