Individual
JAMES LYNDON JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1705 W 2ND, ELK CITY, OK 73644-4455
(580) 225-2511
(580) 821-5536
Mailing address
PO BOX 2339, ELK CITY, OK 73648-2339
(580) 225-2511
(580) 821-5536
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
23119
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00010436
RAILROAD MEDICARE
OK
Enumeration date
08/14/2006
Last updated
07/08/2007
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