Provider Demographics
NPI:1538239520
Name:JOHNSTON, CHAD R (MD)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:R
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1490 N LAFAYETTE ST STE 104
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-2391
Mailing Address - Country:US
Mailing Address - Phone:303-955-5131
Mailing Address - Fax:303-955-5181
Practice Address - Street 1:1490 N LAFAYETTE ST STE 104
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-2391
Practice Address - Country:US
Practice Address - Phone:303-955-5131
Practice Address - Fax:303-955-5131
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036119004207R00000X
CO0058849207RA0401X
CAA95435207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine