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Individual

DARREL JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1200 S 7TH AVE, STE 2, SIOUX FALLS, SD 57105-0998
(605) 336-2140
Mailing address
PO BOX 86430, SIOUX FALLS, SD 57117-6430
(605) 322-4900
(605) 322-4910

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0266
SD
363AM0700X
Medical Physician Assistant
Primary
0266
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6826102
SD
Enumeration date
06/27/2006
Last updated
04/15/2010
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