Anthony William Johnson PA-C

NPI 1407105547 - Physician Assistant - 363A00000X

NPI Details
NPI 1407105547
Gender Male
Enumeration Date 09/05/2012
Last Updated 02/13/2013
Entity Type Individual
Active Over 4 years ago
Practice Location
1094 S BLAIR ST
SALT LAKE CITY UT, 84111-4703, US
Phone (702) 885-6791
Fax
Business Location
1094 S BLAIR ST
SALT LAKE CITY UT, 84111-4703, US
Phone (702) 885-6791
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Oregon
License Number PA158656
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According to our database, Mr. Anthony William Johnson PA-C NPI is 1407105547, taxonomy code is 363A00000X and license number is PA158656, license state is located at Oregon. Anthony William Johnson PA-C physically located at 1094 S Blair St, Salt Lake City UT, 84111-4703. NPI Number Anthony William Johnson PA-C has the Individual type.

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1407105547 NPI number is provided on an as is basis without warranty of any kind. 1407105547 is maintained by the National Plan & Provider Enumeration System. The contents of Anthony William Johnson PA-C are for informational purposes only.