Individual
DANIEL LEROY JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2321 STOUT RD, MENOMONIE, WI 54751-7003
(715) 235-5531
(715) 233-7645
Mailing address
2321 STOUT RD, MENOMONIE, WI 54751-7003
(715) 235-5531
(715) 233-7645
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21494-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30185400
—
WI
Enumeration date
06/12/2006
Last updated
07/08/2007
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