Johnson, Ryan Douglas

Johnson, Ryan Douglas is an individual health care provider with primary practice located at 1840 Woodmoor Dr Ste 102 , Monument CO 80132-9083. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Johnson, Ryan Douglas can be contacted via phone (719) 622-6522.

Contact Information

Primary practice address
1840 Woodmoor Dr Ste 102 Monument CO 80132-9083
Fax: (719) 622-6520
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X DR.0057733 Colorado

Profile Details

NPI number 1184623878
LBN Legal business name Johnson, Ryan Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2005
Last updated Jan 24th, 2024 - about 2 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 1184623878 NPPES
Texas MEDICAID 153159201

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