Provider Demographics
NPI:1215015482
Name:JOHNSON, BOYD A (DO)
Entity Type:Individual
Prefix:DR
First Name:BOYD
Middle Name:A
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2431 W. CALDWELL AVE
Mailing Address - Street 2:VISALIA WALK - IN MEDICAL CLINIC
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277
Mailing Address - Country:US
Mailing Address - Phone:559-627-5555
Mailing Address - Fax:559-734-4509
Practice Address - Street 1:2431 W. CALDWELL AVE
Practice Address - Street 2:VISALIA WALK - IN MEDICAL CLINIC
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277
Practice Address - Country:US
Practice Address - Phone:559-627-5555
Practice Address - Fax:559-734-4509
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A7291207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine