Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jacob Daniel Johnson, DO

Individual provider Vascular Surgery Physician · NPI 1962760124

Dr. Jacob Daniel Johnson, DO is a Vascular Surgery Physician in Taylor, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2012
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

15411 Park Village Blvd
Taylor, MI 48180-4886
Phone: (646) 714-1984
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Vascular Surgery Physician (primary) Taxonomy 2086S0129X · Licence 5101020933 (MI)
Surgery Physician Taxonomy 208600000X · Licence 5101020933 (MI)

Record details

NPI number1962760124
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedApril 25, 2012
Last updated in NPPESNovember 21, 2015
Mailing address15411 Park Village Blvd, Taylor, MI 48180-4886

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