Individual
DR. MARC L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2075 N 1200 W, LAYTON, UT 84041-1616
(801) 779-6200
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 779-6200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
993755261205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
942854057015
—
UT
05
—
942854058645
—
UT
Enumeration date
11/09/2006
Last updated
07/03/2008
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