Individual
JEFFREY W JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1716591205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-00467
UNITED HEALTHCARE
UT
01
—
107006671101
IHC HEALTHPLANS
UT
01
—
110037853
PALMETTO GBA
UT
01
—
16205
PEHP
UT
01
—
2556
DMBA
UT
01
—
QM0000000053
ALTIUS
UT
Enumeration date
05/04/2006
Last updated
11/27/2023
Update your record
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