Jeffery L Johnson, PA Valid NPI

Individual provider · Physician Assistant · Eagle, ID

NPI

1609887801

Type

Individual (Type 1)

Primary specialty

Physician Assistant

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363A00000X

License number

PA416 (ID)

Sex

Male

Sole proprietor

No

Enumerated

2006-08-11

Last updated

2021-02-03