Johnston, Bradford Dixon
Johnston, Bradford Dixon is an sole proprietor health care provider with primary practice located at 1615 Delaware St , Longview WA 98632-2367. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Johnston, Bradford Dixon can be contacted via phone (360) 414-2000.Contact Information
Primary practice address
1615 Delaware St
Longview WA 98632-2367
Phone: (360) 414-2000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | MD27745 | Oregon |
Profile Details
| NPI number | 1487868105 |
|---|---|
| LBN Legal business name | Johnston, Bradford Dixon |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 10th, 2007 |
| Last updated | Oct 30th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487868105 | NPPES |
| Oregon | Other | 858543040 | OREGON REGENCE BCBS |
| Oregon | MEDICAID | 8501041 | OREGON REGENCE BCBS |
| Oregon | MEDICAID | 245799 | OREGON REGENCE BCBS |
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