Mr Jerry Albert Johnstone, PHYSICIAN ASSISTANT | |
1201 Enterprise Ave, Apt 610, Lake City, TX 77573 | |
(806) 396-5583 | |
(806) 366-2713 |
Full Name | Mr Jerry Albert Johnstone |
---|---|
Gender | Male |
Speciality | Physician Assistant |
Location | 1201 Enterprise Ave, Lake City, Texas |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1326370420 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363A00000X | Physician Assistant | PA01624 (Texas) | Primary |
Mailing Address | Practice Location Address |
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Mr Jerry Albert Johnstone, PHYSICIAN ASSISTANT P.o. Box 1107, Stratford, TX 79084 Ph: (806) 396-5583 | Mr Jerry Albert Johnstone, PHYSICIAN ASSISTANT 1201 Enterprise Ave, Apt 610, Lake City, TX 77573 Ph: (806) 396-5583 |