Provider Demographics
NPI:1063678688
Name:JOHNSON, JAMES R (DVM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 W SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53189-7018
Mailing Address - Country:US
Mailing Address - Phone:262-547-0871
Mailing Address - Fax:262-542-0924
Practice Address - Street 1:918 W SUNSET DR
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53189-7018
Practice Address - Country:US
Practice Address - Phone:262-547-0871
Practice Address - Fax:262-542-0924
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-03
Last Update Date:2008-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1465174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian