Individual
MR. CARL B JOHNSTON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
15151 E. HWY 39, LEXINGTON, OK 73051
(405) 527-5676
(405) 527-5521
Mailing address
LARC/HEALTH SERVICES PO BOX 260, LEXINGTON, OK 73051-0260
(405) 527-5676
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1039
OK
Other
Enumeration date
07/24/2009
Last updated
07/24/2009
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