Provider Demographics
NPI:1558235879
Name:JOHNSON, JOHN WAYNE IOKEPA (DC)
Entity type:Individual
Prefix:
First Name:JOHN WAYNE
Middle Name:IOKEPA
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-4904
Mailing Address - Country:US
Mailing Address - Phone:575-434-1455
Mailing Address - Fax:
Practice Address - Street 1:2001 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-4904
Practice Address - Country:US
Practice Address - Phone:575-434-1455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDC-2025-0019111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor