Individual
ANTHONY DAVID JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
460 S 200 W, BOUNTIFUL, UT 84010-7126
(801) 298-1514
Mailing address
460 S 200 W, BOUNTIFUL, UT 84010-7126
(801) 298-1514
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
7283004-1206
UT
363AM0700X
Medical Physician Assistant
7283004-1206
UT
Other
Enumeration date
06/25/2018
Last updated
09/23/2020
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