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NPI Code Detail

MEDICARE: D R JOHNSON, DO, PLC

MEDICARE: D R JOHNSON, DO, PLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician5101013861MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11437227436OTHERPERSONAL NPI

General Provider Information

NPI Number : 1437279718
Entity Type Code : Organization
Provider Name (Legal Business Name) : D R JOHNSON, DO, PLC
Provider Business Mailing Address
First Line : 1430 N CENTER RD
Second Line :
City : SAGINAW
State : MI
Zip : 48638-5581
Country : US
Telephone Number : 989-249-6960
Fax Number :
Provider Business Practice Location Address
First Line : 1430 N CENTER RD
Second Line :
City : SAGINAW
State : MI
Zip : 48638-5581
Country : US
Telephone Number : 989-249-6960
Fax Number :
Authorized Official
Title or Position : SOLE PROPRIETOR
Name : DR. DAWN RENE JOHNSON
Credential : D.O.
Telephone Number : 989-249-6960
Provider Enumeration Date : 03/30/2007
Last Update Date : 07/10/2007

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Directions to “D R JOHNSON, DO, PLC ” Practice Location

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