Individual
JEFFREY A. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1923 S UTICA AVE, ER DEPT, TULSA, OK 74104-6520
(918) 744-3528
(918) 744-3529
Mailing address
1515 N HARVARD AVE, STE E, TULSA, OK 74115-4957
(918) 832-6049
(918) 832-6055
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
24910
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200084670A
—
OK
Enumeration date
06/19/2006
Last updated
10/04/2011
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