Individual
MARK ROLFE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
32 W 200 S # 410, SALT LAKE CITY, UT 84101-1603
(801) 960-4890
(801) 960-4890
Mailing address
113 PLEASANT VALLEY DR STE 210, BOERNE, TX 78006-5683
(830) 267-4575
(830) 214-2576
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
184901-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1001176
—
UT
Enumeration date
08/22/2005
Last updated
04/23/2020
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