Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 0135 | NH |
Y | 222Z00000X | Podiatrist | 0135 | NH |
N | 213E00000X | Podiatrist | 1499 | MA |
N | 222Z00000X | Podiatrist | 1499 | MA |
NPI | 1023088416 |
---|---|
Provider Name | David Joseph Johns |
First Address | Londonderry, NH 03053-2706 |
Second Address | Worcester, MA 01604-4757 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2006 |
Last Update Date | 28/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0362697 | (05) | MA |
T79888 | (02) |