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NPI Code Detail

MEDICARE: BARBARA ANN JOHNSON MD

MEDICARE: BARBARA ANN JOHNSON MD
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
12084P0800XPsychiatry Physician40019MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11564702OTHERMNMEDICA
2137T1J0OTHERMNBCBS OF MN

General Provider Information

NPI Number : 1003898081
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA ANN JOHNSON MD
Provider Business Mailing Address
First Line : 4737 COUNTY ROAD 101
Second Line : STE 124
City : MINNETONKA
State : MN
Zip : 55345-2634
Country : US
Telephone Number : 612-710-3671
Fax Number : 763-295-4946
Provider Business Practice Location Address
First Line : 4737 COUNTY ROAD 101
Second Line : STE 124
City : MINNETONKA
State : MN
Zip : 55345-2634
Country : US
Telephone Number : 612-710-3671
Fax Number : 763-295-4946
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2005
Last Update Date : 07/08/2007

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Directions to “ BARBARA ANN JOHNSON MD” Practice Location

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