IndividualActive
David Johnson
NPI 1891375416 · Medical Physician Assistant · Highland, UT
Provider details
- NPI number
- 1891375416
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 12423884-8906 (UT)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
11578 N Broadleaf Hollow Ln
Highland, UT 84003-5633
Phone: (208) 577-8820
Approximate (ZIP-level) locationGet directions
Mailing address
11578 N Broadleaf Hollow Ln
Highland, UT 84003-5633
Registry dates
- Enumerated
- 2021-04-08
- Last updated
- 2021-10-22
- Certified
- 2021-10-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.