Kyle Robert Johnson, MD is a medicare enrolled "Emergency Medicine" physician in Douglas, Wyoming. His current practice location is
111 S 5th St, Douglas, Wyoming. You can reach out to his office (for appointments etc.) via phone at
(307) 358-2122.
Kyle Robert Johnson is licensed to practice in Wyoming (license number 16983A) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1063972487.
Physician's Profile
Full Name | Kyle Robert Johnson |
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Gender | Male |
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Speciality | Emergency Medicine |
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Location | 111 S 5th St, Douglas, Wyoming |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1063972487
- Provider Enumeration Date: 03/21/2019
- Last Update Date: 06/24/2024
Medicare PECOS Information:
- PECOS PAC ID: 5294138277
- Enrollment ID: I20210728002554
Medical Identifiers
Medical identifiers for Kyle Robert Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1063972487 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207P00000X | Emergency Medicine | 16983A (Wyoming) | Primary |
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. Kyle Robert Johnson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kyle Robert Johnson, MD 111 S 5th St, Douglas, WY 82633-2434 Ph: (307) 358-2122 | Kyle Robert Johnson, MD 111 S 5th St, Douglas, WY 82633-2434 Ph: (307) 358-2122 |
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