Individual
MARK JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6161 S YALE AVE, TULSA, OK 74136-1902
(918) 494-1805
(918) 494-4573
Mailing address
6600 S YALE AVE STE 1400, TULSA, OK 74136-3331
(888) 247-0125
(918) 502-8210
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
1205298122
OK
207XX0801X
Orthopaedic Trauma Physician
Primary
6194
OK
Other
Enumeration date
03/22/2016
Last updated
03/20/2024
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