Individual
DR. MICHAEL E. JOHNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6800 NW 39TH EXPY, BETHANY, OK 73008-2513
(405) 789-6711
(405) 440-6750
Mailing address
6800 NW 39TH EXPY, BETHANY, OK 73008-2513
(405) 789-6711
(405) 440-6750
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
28900
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200444790 B
—
OK
Enumeration date
04/23/2009
Last updated
01/25/2016
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