Provider Demographics
NPI:1023088416
Name:JOHNS, DAVID JOSEPH (DPM)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:JOSEPH
Last Name:JOHNS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-2706
Mailing Address - Country:US
Mailing Address - Phone:603-401-2031
Mailing Address - Fax:
Practice Address - Street 1:37 PLANTATION ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-4757
Practice Address - Country:US
Practice Address - Phone:413-584-4040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1499213E00000X
NH0135213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0362697Medicaid
MAY70891Medicare PIN
NHY70891Medicare PIN
T79888Medicare UPIN
MA0362697Medicaid
MAY70891Medicare Oscar/Certification