# JASON DOUGLAS JOHNSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1073044343
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 6679 | OK | — |
| 207Q00000X | Family Medicine Physician | MED-PHYS-LIC-132637 | MT | Yes |

## Other

- **Enumeration date:** 03/27/2017
- **Last updated:** 11/16/2025