Provider Demographics
NPI:1467686196
Name:JOHNSON, DANIEL JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JAMES
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1252 COUNTY RD 8
Mailing Address - Street 2:
Mailing Address - City:KEYSTONE
Mailing Address - State:CO
Mailing Address - Zip Code:80435-0000
Mailing Address - Country:US
Mailing Address - Phone:970-486-6677
Mailing Address - Fax:970-468-7908
Practice Address - Street 1:1252 COUNTY RD 8
Practice Address - Street 2:
Practice Address - City:KEYSTONE
Practice Address - State:CO
Practice Address - Zip Code:80435-0000
Practice Address - Country:US
Practice Address - Phone:970-486-6677
Practice Address - Fax:970-468-7908
Is Sole Proprietor?:No
Enumeration Date:2009-05-09
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 445 684207P00000X
CODR.0059792207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine