Provider Demographics
NPI:1033565908
Name:JOHNSON, EMILY JEANNE (MD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:JEANNE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4725 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80216-2220
Mailing Address - Country:US
Mailing Address - Phone:303-458-5302
Mailing Address - Fax:
Practice Address - Street 1:2101 E 48TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80216-2253
Practice Address - Country:US
Practice Address - Phone:303-458-5302
Practice Address - Fax:303-583-0152
Is Sole Proprietor?:No
Enumeration Date:2016-05-10
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.146915207Q00000X
CODR.0062604207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine