Active NPI
Gary Erle Johnston, D.O.
- Adult Medicine Physician
- Hodgen, OK
National Provider Identifier
1962537902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- OK1230
- Practice address
- 53468 Mineral Springs Rd
Hodgen, OK 74939-3064 - Phone
- (918) 653-7831
- NPI assigned
- Feb 22, 2007
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | OK1230 | OK | Primary |
Addresses
Primary practice location
53468 Mineral Springs Rd
Hodgen, OK 74939-3064
Mailing address
1501 Cottonwood Dr
Poteau, OK 74953-2048
Phone (918) 647-7171
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OK1230 | OK | MD | Adult Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1962537902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 COTTONWOOD DR",
"city": "POTEAU",
"state": "OK",
"postal_code": "749532048",
"telephone_number": "918-647-7171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "53468 MINERAL SPRINGS RD",
"city": "HODGEN",
"state": "OK",
"postal_code": "749393064",
"telephone_number": "918-653-7831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "GARY",
"middle_name": "ERLE",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-22",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "OK",
"license": "OK1230",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hodgen, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.