Johnson, Russell P

Johnson, Russell P is an individual health care provider with primary practice located at 7021 Spring Mountain Rd , Las Vegas NV 89117-3818. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Johnson, Russell P can be contacted via phone (702) 803-2222.

Contact Information

Primary practice address
7021 Spring Mountain Rd Las Vegas NV 89117-3818
Phone: (702) 803-2222
Fax: (702) 829-7269
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X MA003569L Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X MA003569L Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA1753 Nevada

Profile Details

NPI number 1497712483
LBN Legal business name Johnson, Russell P
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Nov 27th, 2020 - about 6 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 1497712483 NPPES
Nevada Other 1336749811 GROUP NPI
Nevada MEDICAID 1497712483 GROUP NPI

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