Individual
MR. RANDALL ROY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1305 W AMERICAN DR, NEENAH, WI 54956-1993
(920) 725-9373
(920) 720-7392
Mailing address
1305 WEST AMERICAN DRIVE, NEENAH, WI 54956-2883
(920) 725-9373
(920) 720-7392
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
47081
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3455700
—
WI
01
—
P00144769
RAILROAD MEDICARE
WI
Enumeration date
06/13/2006
Last updated
08/10/2022
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