Johnson, Russell Adam
Johnson, Russell Adam is an sole proprietor health care provider with primary practice located at 3211 W 20Th St Ste D , Greeley CO 80634-6566. He recently has only one registered license in Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, which is considered as his primary health care specialty. Johnson, Russell Adam can be contacted via phone (970) 356-3100.Contact Information
Primary practice address
3211 W 20Th St Ste D
Greeley CO 80634-6566
Phone: (970) 356-3100
Fax: (970) 356-4827
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | 32618 | Colorado |
Profile Details
| NPI number | 1831112341 |
|---|---|
| LBN Legal business name | Johnson, Russell Adam |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 25th, 2006 |
| Last updated | Jul 9th, 2007 - about 19 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 | 1831112341 | NPPES |
| Colorado | MEDICAID | 01326180 | |
| Colorado | Other | 065216 | |
| Colorado | Other | 643345 |
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