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Individual
TROY JOHNSON
Active
Individual
TROY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA.C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
379295-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107033706101
SELECTHEALTH
UT
01
—
231831
ALTIUS HEALTH PLANS
UT
01
—
80922
PUBLIC EMPLOYEES HEALTH P
UT
01
—
841433992TRY
EDUCATORS MUTUAL
UT
Enumeration date
08/03/2006
Last updated
03/08/2010
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