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Individual

PAUL L JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1025 MARSH ST, MANKATO, MN 56001-4752
(507) 345-2623
(507) 389-4685
Mailing address
20201 586TH LN, MANKATO, MN 56001-7893

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
41487
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05F00JO
BLUE CROSS BLUE SHIELD
MN
01
123607
UCARE
01
2000870
MEDICA
01
967551028364
PREFERRED ONE
01
HP57496
HEALTH PARTNERS
Enumeration date
08/10/2006
Last updated
11/20/2007
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