Individual
LANCE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
709 N CZECH HALL RD, YUKON, OK 73099
(405) 494-8600
Mailing address
PO BOX 1867, BETHANY, OK 73008-1867
(405) 494-8600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5024
OK
Other
Enumeration date
03/07/2023
Last updated
03/07/2023
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