Johnston, Bruce William

Johnston, Bruce William is an individual health care provider with primary practice located at 200 1St St Sw , Rochester MN 55905-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics, which is considered as his primary health care specialty. Johnston, Bruce William can be contacted via phone (507) 284-2511.

Contact Information

Primary practice address
200 1St St Sw Rochester MN 55905-0001
Phone: (507) 284-2511
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics 207VX0000X 34612 Minnesota

Profile Details

NPI number 1770563488
LBN Legal business name Johnston, Bruce William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2006
Last updated Oct 31st, 2008 - about 18 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 1770563488 NPPES
Wisconsin MEDICAID 35175200
Wisconsin MEDICAID 387320000
Wisconsin MEDICAID ENROLLED
Wisconsin Other 160023875

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