Johnson, Blake G

Johnson, Blake G is an individual health care provider with primary practice located at 738 N College Rd Suite A, Twin Falls ID 83301-3385. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Johnson, Blake G can be contacted via phone (208) 814-7000.

Contact Information

Primary practice address
738 N College Rd Suite A Twin Falls ID 83301-3385
Phone: (208) 814-7000
Fax: (208) 734-7294
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X M7285 Idaho

Profile Details

NPI number 1619913381
LBN Legal business name Johnson, Blake G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2006
Last updated Dec 29th, 2014 - about 12 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 1619913381 NPPES
Idaho MEDICAID 804193700
Idaho Other P00654623

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