Cody Johnson

NPI #1184392011 in Boise, Idaho

Provider Information

NPI Number: 1184392011
Entity Type: Individual
Name: Cody Johnson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Enumeration Date: Sep 3, 2021
Last Updated: Nov 30, 2022

Practice Location

Address: 190 E BANNOCK ST FL 10
City: Boise
State: Idaho
ZIP Code: 83712-6241
Phone: (208) 381-5500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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