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Individual

MR. JAMES FRED JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2301 25TH ST S, SUITE I, FARGO, ND 58103
(701) 241-9300
(701) 235-4525
Mailing address
2301 25TH ST S, SUITE I, FARGO, ND 58103
(701) 241-9300
(701) 235-4525

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
31925
MN
207X00000X
Orthopaedic Surgery Physician
Primary
3782
ND
207X00000X
Orthopaedic Surgery Physician
5131
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0023210
WELLMARK BCBS
SD
01
0900489
MEDICA
05
14183
ND
01
200026912
RR MEDICARE
01
58A11JO
MN BCBS
MN
01
594741014527
PREFERRED ONE COMMUNITY HEALTH
05
6402130
SD
05
840563800
MN
01
HP19542
HEALTH PARTNERS
01
JOH23210
BCBS ND
ND
Enumeration date
02/01/2006
Last updated
04/28/2010
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