Individual provider · Type 1 NPI
Jacob Daniel Johnson, DO
Vascular Surgery Physician · Taylor, MI
NPI number
1962760124
Active
Practice location
15411 Park Village Blvd
Taylor, MI 48180-4886
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Vascular Surgery Physician Primary | 2086S0129X | 5101020933 (MI) |
| Surgery Physician | 208600000X | 5101020933 (MI) |
Vascular Surgery Physician: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
About NPI 1962760124
Jacob Daniel Johnson, DO's National Provider Identifier is 1962760124, issued on Apr 25, 2012. The primary taxonomy on file is Vascular Surgery Physician (2086S0129X), and the practice location is in Taylor, MI. The record was last updated on Nov 21, 2015.