Individual
DR. CLARK A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
3120 W BELLTOWER DR STE 100, MERIDIAN, ID 83646-7744
(208) 516-3617
(208) 314-2029
Mailing address
3120 W BELLTOWER DR STE 100, MERIDIAN, ID 83646-7744
(208) 516-3617
(208) 314-2029
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
P242
ID
213ES0103X
Foot & Ankle Surgery Podiatrist
POD.0000757
CO
Other
Enumeration date
04/24/2012
Last updated
02/11/2020
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