Individual
DR. GREGORY A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
305 EAST 12TH STREET, KAUKAUNA, WI 54130
(920) 766-4656
(920) 766-4659
Mailing address
305 EAST 12TH STREET, KAUKAUNA, WI 54130
(920) 766-4656
(920) 766-4659
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0028536
WI
207Q00000X
Family Medicine Physician
Primary
28536
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31483400
—
WI
Enumeration date
04/25/2006
Last updated
06/11/2010
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