Individual
TIMOTHY JAMES JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2529
(217) 383-3313
Mailing address
611 W PARK ST, URBANA, IL 61801-2529
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
45237
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
577445400
—
MN
Enumeration date
03/07/2006
Last updated
03/30/2023
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