Individual
DR. CRAIG T JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
265 GRIFFIN ST E, AMERY, WI 54001-1439
(715) 268-8000
(715) 268-1376
Mailing address
265 GRIFFIN ST E, AMERY, WI 54001-1439
(715) 268-8000
(715) 268-0311
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24805
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00496
MEDICARE GROUP
WI
01
—
1007583
PREFERRED ONE
—
05
—
30612400
—
WI
01
—
46Q68JO
BC/BS MINN
—
01
—
49170
MEDICARE GROUP
WI
Enumeration date
06/17/2005
Last updated
12/21/2007
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