Dr Jacob Daniel Johnson, DO is a
Surgery - Vascular Surgery physician based in Taylor, Michigan. Dr Jacob Daniel Johnson is licensed to practice in Michigan (license number 5101020933) and his current practice location is 15411 Park Village Blvd, Taylor, Michigan. He can be reached at his office (for appointments etc.) via phone at
(646) 714-1984.
NPI number for Dr Jacob Daniel Johnson is 1962760124 and his current mailing address is 15411 Park Village Blvd, Taylor, Michigan. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1962760124.
Physician's Profile
Full Name | Dr Jacob Daniel Johnson |
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Gender | Male |
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Speciality | Surgery - Vascular Surgery |
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Location | 15411 Park Village Blvd, Taylor, Michigan |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1962760124
- Provider Enumeration Date: 04/25/2012
- Last Update Date: 11/21/2015
Medical Identifiers
Medical identifiers for Dr Jacob Daniel Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1962760124 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2086S0129X | Surgery - Vascular Surgery | 5101020933 (Michigan) | Primary |
208600000X | Surgery | 5101020933 (Michigan) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jacob Daniel Johnson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Jacob Daniel Johnson, DO 15411 Park Village Blvd, Taylor, MI 48180-4886 Ph: () - | Dr Jacob Daniel Johnson, DO 15411 Park Village Blvd, Taylor, MI 48180-4886 Ph: (646) 714-1984 |
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