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Individual
LEAH MARIE JOHNSON
Active
Individual
LEAH MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12677
SD
207Q00000X
Family Medicine Physician
33644
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1231654
—
IA
01
—
1336127828
GROUP NPI
IA
Enumeration date
12/13/2005
Last updated
04/18/2022
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