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Individual

DR. RANDALL M JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
184 US HIGHWAY 41 E, NEGAUNEE, MI 49866-9606
(906) 315-2607
(906) 475-9312
Mailing address
184 US HIGHWAY 41 E, NEGAUNEE, MI 49866-9606
(906) 315-2607
(906) 475-9312

Taxonomy

Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
RJ040842
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0521038
BCC PROVIDER ID
MI
05
1862351
MI
05
2671990
MI
01
3903600261
BCBS OF MI PROVIDER ID
MI
05
5100662
MI
Enumeration date
10/26/2006
Last updated
07/09/2007
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