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NPI Code Detail

MEDICARE: MICHAEL WYNN JOHNSON MD

MEDICARE: MICHAEL WYNN 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
1207X00000XOrthopaedic Surgery PhysicianMD23859OR
2207X00000XOrthopaedic Surgery Physician6782459-1205UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073582862
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL WYNN JOHNSON MD
Provider Business Mailing Address
First Line : PO BOX 27128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0128
Country : US
Telephone Number : 801-501-5500
Fax Number : 801-501-5800
Provider Business Practice Location Address
First Line : 9450 S 1300 E
Second Line : STE 120
City : SANDY
State : UT
Zip : 84094-5555
Country : US
Telephone Number : 801-501-5500
Fax Number : 801-501-5800
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2006
Last Update Date : 06/09/2011

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Directions to “ MICHAEL WYNN JOHNSON MD” Practice Location

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