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General NPI Number Information
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NPI Number | 1497971733
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Entity Type | Individual
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Provider Name | PAUL DAVIS JOHNSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 12/08/2011
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Provider Practice Location Address
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Address Line | 7100 S I 35 SERVICE RD SUITE # 7
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City | OKLAHOMA CITY
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State | OK
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Zip | 73149-2740
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Country | US
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Telephone | 405-632-1002
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Fax | 405-632-3131
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Provider Business Mailing Address
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Address Line | 7100 S I 35 SERVICE RD SUITE # 7
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City | OKLAHOMA CITY
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State | OK
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Zip | 73149-2740
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Country | US
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Telephone | 405-632-1002
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Fax | 405-632-3131
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 14767
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License Number State | OK
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