# JOEL A JOHNSON, M.D., P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Upper Great Lakes Vascular, P.C
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366425852
- **Authorized official:** JOEL A JOHNSON M.D. (PRESIDENT)
- **Authorized official phone:** (906) 225-7701

## Contact information

- **Practice address:** 1414 W FAIR AVE, STE 215, MARQUETTE, MI 49855-2675
- **Practice address phone:** (906) 225-7701
- **Practice address fax:** (906) 225-7705
- **Mailing address:** 1414 W FAIR AVE, STE 348, MARQUETTE, MI 49855-2675
- **Mailing address phone:** (906) 225-3964
- **Mailing address fax:** (906) 226-3875

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 4301057398 | MI | Yes |

## Other

- **Enumeration date:** 11/29/2005
- **Last updated:** 08/22/2020