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General NPI Number Information
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NPI Number | 1972545861
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Entity Type | Individual
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Provider Name | SCOTT EDWARD JOHNSON DO
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Gender | Male
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 09/02/2008
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Provider Practice Location Address
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Address Line | 5848 S 300 E
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City | MURRAY
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State | UT
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Zip | 84107-6121
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Country | US
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Telephone | 801-314-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 5848 S 300 E
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City | MURRAY
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State | UT
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Zip | 84107-6121
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Country | US
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Telephone | 801-314-4900
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Fax |
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 3764581205
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License Number State | UT
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