Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | M-6039 | ID |
N | 207XS0106X | Orthopaedic Hand Surgeon | M-6039 | ID |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | M-6039 | ID |
N | 207XS0117X | Orthopaedic Spine Surgeon | M-6039 | ID |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | M-6039 | ID |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | M-6039 | ID |
N | 207XX0801X | Orthopaedic Trauma Surgeon | M-6039 | ID |
NPI | 1114940699 |
---|---|
Provider Name | Dr. James M Johnston |
First Address | Boise, ID 83712-6241 |
Second Address | Boise, ID 83702-5099 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 28/03/2011 |