Individual
MICHAEL WYNN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9450 S 1300 E, STE 120, SANDY, UT 84094-5555
(801) 501-5500
(801) 501-5800
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 501-5500
(801) 501-5800
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
6782459-1205
UT
207X00000X
Orthopaedic Surgery Physician
MD23859
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073582862
—
UT
Enumeration date
03/15/2006
Last updated
06/09/2011
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