1639260565

Everything you always wanted to know about DR. JOHNSON DACLYNN M.D. but were afraid to ask.

DR. JOHNSON DACLYNN M.D.

You can also download the this 1639260565 data report as csv | excel | json | xml
Provider Prefix Provider Last Name Provider First Name Provider Credential
DR. JOHNSON DACLYNN M.D.
Gender:
Male
Enumeration date:
2006-09-27
Last update date:
2012-05-18
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
Yes
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Identifiers

identifier description issuer state
F38558 Medicare UPIN none ID

Taxonomies

Taxonomy State License Number Primary?
2085R0204X Vascular & Interventional Radiology ID M7497

Phone Numbers

Type Number
Mailing Address Telephone Number 2084368340
Practice Location Address Telephone Number 2084368340
Mailing Address Fax Number 2084363956
Practice Location Address Fax Number 2084363956

Addresses

Type Address City State Postal Country
Mailing Address 1218 9TH ST STE 10 RUPERT ID 83350 ID
Practice Location Address 1218 9TH ST STE 10 RUPERT ID 83350 ID

Other NPI Records that share a phone number

NPI Name Address State City
1457656217 MINI-CASSIA SURGICAL PC
Organization
1218 9TH ST ID RUPERT

Other NPI Records that share an identifier

NPI Name Address State City Identifier types that matches
1619913381 JOHNSON, BLAKE
Individual
738 N COLLEGE RD ID TWIN FALLS Identifier: F38558 (Medicare UPIN)