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General NPI Number Information
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NPI Number | 1205017530
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Entity Type | Organization
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Legal Business Name | DONNA A. JOHNSON, MD, PLLC
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 11/15/2007
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Provider Practice Location Address
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Address Line | 8100 S WALKER AVE STE 200
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City | OKLAHOMA CITY
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State | OK
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Zip | 73139-9402
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Country | US
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Telephone | 405-629-5343
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Fax |
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Provider Business Mailing Address
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Address Line | 8100 S WALKER AVE STE 200
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City | OKLAHOMA CITY
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State | OK
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Zip | 73139-9402
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Country | US
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Telephone | 405-629-5343
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DONNA A JOHNSON
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Credential |
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Telephone | 405-629-5343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 18635
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License Number State | OK
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