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
Fax: (970) 356-4827
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831112341 NPPES
Colorado MEDICAID 01326180
Colorado Other 065216
Colorado Other 643345

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