DR. JACOB DANIEL JOHNSON DO NPI 1962760124

NPI Information

NPI: 1962760124
Provider Name: DR. JACOB DANIEL JOHNSON, DO
Classification: Surgery - 2086S0129X
Entity Type: Individual

Specialization: Vascular Surgery

Address:
15411 PARK VILLAGE BLVD
TAYLOR, MI
ZIP 48180
Phone: (646) 714-1984
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DR. Jacob Daniel Johnson, DO is a vascular surgery surgery in Taylor, MI. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. DR. Jacob Daniel Johnson, DO NPI is 1962760124. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

15411 PARK VILLAGE BLVD
TAYLOR, MI
ZIP 48180-886
Phone: (646) 714-1984

The enumeration date for this NPI number is 4/25/2012 and was last updated on 11/21/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208600000X	Surgery		5101020933	MICHIGAN	No
2	2086S0129X	Surgery	Vascular Surgery	5101020933	MICHIGAN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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