Johnson Acopan Jr., PHYSICIAN ASSISTANT
Individual provider Active NPI Physician Assistant · McConnell Afb, KS
NPI 1972369064 · NPPES record last updated Nov 19, 2025
Key facts
- NPI
- 1972369064
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 57950 Leavenworth St BLDG 250
McConnell Afb, KS 67221-3505 - Phone
- (316) 759-6300
- NPI assigned
- Feb 26, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
57950 Leavenworth St BLDG 250
McConnell Afb, KS 67221-3505
Mailing address
57950 Leavenworth St BLDG 250
McConnell Afb, KS 67221-3505
Other providers in McConnell Afb, KS
- 22 MDG
- 22D Medgrp-McConnell
- 22D Medgrp-McConnell
- David A Alcindor
- Michelle Renee Alders
- Natalie Dawn Ashmore
- Brian Russell Balcolm
- Diane Sue Bidwell
All providers in McConnell Afb, KS · Physician Assistant in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.