Johnson, Adam

Johnson, Adam is an individual health care provider with primary practice located at 625 E Broadway Ave , Jackson WY 83001-8642. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Johnson, Adam can be contacted via phone (307) 739-7250.

Contact Information

Primary practice address
625 E Broadway Ave Jackson WY 83001-8642
Phone: (307) 739-7250
Fax: (307) 739-7249
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 6447817-1205 Utah
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 7834A Wyoming

Profile Details

NPI number 1043364797
LBN Legal business name Johnson, Adam
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 22nd, 2007
Last updated Feb 10th, 2021 - about 4 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 1043364797 NPPES
Wyoming MEDICAID 139580000

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