Individual
DR. JON MARK JOHNSON SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
608 S HESTER ST, STILLWATER, OK 74074-4516
(405) 377-8000
(405) 377-8040
Mailing address
608 S HESTER ST, STILLWATER, OK 74074-4516
(405) 377-8000
(405) 377-8040
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
15120
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100125430B
—
OK
Enumeration date
07/21/2005
Last updated
07/08/2007
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