Individual
MR. MARK A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
2700 NW STEWART PKWY, ROSEBURG, OR 97470-1281
(541) 677-3607
Mailing address
326 FOX LN, ROSEBURG, OR 97470-9509
(541) 672-4490
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
7026
OR
1835P1200X
Pharmacotherapy Pharmacist
Primary
7026
OR
Other
Enumeration date
03/14/2007
Last updated
09/11/2025
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