Individual
JOHNNY JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1401 E VAN BUREN AVE, MCALESTER, OK 74501-4245
(918) 426-0240
(918) 423-4051
Mailing address
6600 S YALE AVE, SUITE 1400, TULSA, OK 74136-3347
(918) 488-6001
(918) 488-6010
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
29774
OK
208000000X
Pediatrics Physician
37489
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0278374
—
IA
05
—
200484430A
—
OK
Enumeration date
07/03/2006
Last updated
07/02/2013
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