Individual
DR. PHILIP QUENTIN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2829 UNIVERSITY DR S, SUITE 202, FARGO, ND 58103-6050
(701) 478-0307
(701) 478-0309
Mailing address
2829 UNIVERSITY DR S, SUITE 202, FARGO, ND 58103-6050
(701) 478-0307
(701) 478-0309
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
25154
AZ
207X00000X
Orthopaedic Surgery Physician
34857
MN
207X00000X
Orthopaedic Surgery Physician
Primary
6195
ND
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
25154
AZ
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
34857
MN
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
6195
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16785
—
ND
Enumeration date
05/16/2006
Last updated
06/30/2015
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