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NPI Code Detail

MEDICARE: TERRANCE JOHNSON ORTHOPEDIC SURGERY PA

MEDICARE: TERRANCE JOHNSON ORTHOPEDIC SURGERY PA
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
1174400000XSpecialist22385MN

General Provider Information

NPI Number : 1821260134
Entity Type Code : Organization
Provider Name (Legal Business Name) : TERRANCE JOHNSON ORTHOPEDIC SURGERY PA
Provider Business Mailing Address
First Line : 3807 GREENLEAF AVE NW
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-5817
Country : US
Telephone Number : 218-751-9746
Fax Number : 218-759-0620
Provider Business Practice Location Address
First Line : 3807 GREENLEAF AVE NW
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-5817
Country : US
Telephone Number : 218-751-9746
Fax Number : 218-759-0620
Authorized Official
Title or Position : CLAIMS MGR
Name : RITA K DREWS
Credential :
Telephone Number : 218-751-9746
Provider Enumeration Date : 03/26/2008
Last Update Date : 03/26/2008

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Directions to “TERRANCE JOHNSON ORTHOPEDIC SURGERY PA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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