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:
Health care specialties
| Specialty | Code | License # | 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 5 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 | 1043364797 | NPPES |
| Wyoming | MEDICAID | 139580000 |
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