Dr. John Russell Johansson
Sports Medicine Doctor
67 Lincoln St
Essex Junction
, Vermont 05452-3235
Dr. John Russell Johansson
Sports Medicine Doctor
67 Lincoln St
Essex Junction
, Vermont 05452-3235
(802) 878-9278
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About
Features
Specialties
- Sports Medicine Doctor
Languages spoken
- English
Location
First Address
- Dr. John Russell Johansson
- 67 Lincoln St
- Essex Junction, VT
- Zip : 05452-3235
- Phone : (802) 878-9278
Second Address
- Dr. John Russell Johansson
- 67 Lincoln St
- Essex Junction, VT
- Zip : 05452-3235
- Fax : (802) 878-9961
- Phone : (802) 878-1003
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 204C00000X | Sports Medicine Doctor | VT 0000304 | VT |
National Provider Identifier
| NPI | 1316005960 |
|---|---|
| Provider Name | Dr. John Russell Johansson |
| First Address | Essex Junction, VT 05452-3235 |
| Second Address | Essex Junction, VT 05452-3235 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/12/2006 |
| Last Update Date | 18/04/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| B-57919 | (02) | VT |
| JOVT-9125 | (05) | VT |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.