Individual
DR. JEREMIAH DAVID JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2700 VIKINGS CIR, EAGAN, MN 55121-1002
(952) 456-7600
Mailing address
4200 DAHLBERG DR STE 300, GOLDEN VALLEY, MN 55422-4841
(952) 512-5600
(952) 512-5651
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
71712
MN
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
71712
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2015
Last updated
08/19/2024
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