| Sara L. Johnson, Md | |
|
496 Shoup Ave W Suite E Twin Falls ID 83301-5043 | |
| (208) 733-2885 | |
| (208) 734-3352 |
| Full Name | Sara L. Johnson, Md |
|---|---|
| Speciality | Clinic/center |
| Location | 496 Shoup Ave W, Twin Falls, Idaho |
| Authorized Official Name and Position | Sara Johnson (OWNER) |
| Authorized Official Contact | 2087332885 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sara L. Johnson, Md 496 Shoup Ave W Suite E Twin Falls ID 83301-5043 Ph: (208) 733-2885 | Sara L. Johnson, Md 496 Shoup Ave W Suite E Twin Falls ID 83301-5043 Ph: (208) 733-2885 |
| NPI Number | 1346306974 |
|---|---|
| Provider Enumeration Date | 12/28/2006 |
| Last Update Date | 06/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346306974 | NPI | - | NPPES |
| 8H757 | Other | ID | BLUE CROSS OF IDAHO |
| 000010017978 | Other | ID | REGENCE BLUE SHIELD OF ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | M4188 (Idaho) | Primary |
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