Individual
DEREK SCOTT JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1120 S UTICA AVE, TULSA, OK 74104-4012
(918) 579-1000
Mailing address
11195 S 55TH WEST AVE, SAPULPA, OK 74066-9392
(918) 760-2580
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
5039
OK
Other
Enumeration date
03/16/2011
Last updated
01/18/2023
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