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Individual
BENJAMIN FREDRICK JOHNSON
Active
Individual
BENJAMIN FREDRICK JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
7771155-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10000009766001
REGENCE BLUE CROSS BLUE SHIELD
UT
05
—
1689991358
—
UT
01
—
U000078668
MEDICARE PTAN
UT
Enumeration date
04/21/2010
Last updated
12/19/2013
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