Individual
DR. BARRY DUANE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 S CARPENTER AVE, KINGSFORD, MI 49802-5518
(906) 776-5480
(906) 228-0203
Mailing address
PO BOX 549, IRON MOUNTAIN, MI 49801-0549
(906) 774-1313
(906) 776-5639
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
4301042058
MI
2084N0400X
Neurology Physician
4301042058
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1302200421
BCBS MI
MI
05
—
30305300
—
WI
05
—
3463356 10
—
MI
01
—
P00626141
RR MEDICARE
MI
Enumeration date
10/24/2006
Last updated
06/19/2015
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