Individual
MR. TIMOTHY W JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS PA C
Contact information
Practice address
33280 STONEY CREEK AVE, SEWARD, AK 99664-3633
(907) 224-7094
(907) 224-7094
Mailing address
PO BOX 3633, SEWARD, AK 99664-3633
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
592
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CL3490
—
AK
Enumeration date
11/27/2006
Last updated
07/20/2009
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