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Individual
DR. WILLIS BRADLEY JOHNSTON
Active
Individual
DR. WILLIS BRADLEY JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
132
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100780620A
—
OK
Enumeration date
02/27/2006
Last updated
05/02/2014
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