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NPI Code Detail

MEDICARE: MARCUS DARREN JOHNSON II

MEDICARE: MARCUS DARREN JOHNSON II
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
1175T00000XPeer SpecialistOK

General Provider Information

NPI Number : 1710804992
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCUS DARREN JOHNSON II
Provider Business Mailing Address
First Line : 6333 E SKELLY DR
Second Line :
City : TULSA
State : OK
Zip : 74135-6106
Country : US
Telephone Number : 918-664-4224
Fax Number :
Provider Business Practice Location Address
First Line : 6333 E SKELLY DR
Second Line :
City : TULSA
State : OK
Zip : 74135-6106
Country : US
Telephone Number : 918-664-4224
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2026
Last Update Date : 06/30/2026

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Directions to “ MARCUS DARREN JOHNSON II ” Practice Location

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