Individual
JUDITH L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1000 E 1ST ST, SUITE LL, DULUTH, MN 55805-2297
(218) 722-5629
(218) 722-5148
Mailing address
1000 E 1ST ST, SUITE LL, DULUTH, MN 55805-2297
(218) 722-5629
(218) 722-5148
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
40719
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01017175
PREFERRED ONE
—
01
—
0708040
MEDICA
MN
01
—
123030
UCARE
MN
05
—
199824200
—
MN
01
—
31B35JO
BLUE CROSS BLUE SHIELD
MN
05
—
32459800
—
WI
01
—
A011
TRICARE
—
01
—
HP26562
HEALTH PARTNERS
MN
Enumeration date
03/17/2006
Last updated
07/08/2007
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