Individual
WAYNE ANTHONY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
904 SW 38TH ST, LAWTON, OK 73505-7021
(580) 353-8600
(580) 353-8607
Mailing address
PO BOX 8679, BELFAST, ME 04915-8679
(580) 353-8600
(580) 353-8607
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
19138
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200003890B
—
OK
01
—
7986387
AETNA
—
Enumeration date
07/13/2006
Last updated
01/28/2011
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