Individual
DR. WENDELL C JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5444 S. GREEN ST., MURRAY, UT 84123-5632
(801) 262-2647
(801) 262-3897
Mailing address
5444 S. GREEN ST., MURRAY, UT 84123-5632
(801) 262-8120
(801) 262-5721
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
276179-1205
UT
2085R0202X
Diagnostic Radiology Physician
276179-1205
UT
2085R0202X
Diagnostic Radiology Physician
M-10293
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D3403
—
UT
Enumeration date
06/07/2006
Last updated
11/13/2012
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