Individual
MR. BLAKE WESLEY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2000 S WHEELING AVE STE 900, TULSA, OK 74104-5647
(918) 403-6284
(918) 403-6323
Mailing address
2000 S WHEELING AVE STE 900, TULSA, OK 74104-5647
(918) 403-6284
(918) 403-6323
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
OK
Other
Enumeration date
11/11/2014
Last updated
04/03/2020
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