Individual
DAVID LYLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5169 S COTTONWOOD ST, SUITE 510, MURRAY, UT 84107-6767
(801) 507-3513
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 507-3513
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5314229-1206
UT
363AM0700X
Medical Physician Assistant
5314229-8002
UT
363AS0400X
Surgical Physician Assistant
5314229-8002
UT
Other
Enumeration date
07/20/2007
Last updated
06/09/2016
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