Individual
DR. COREY B JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1219 N 400 E, LOGAN, UT 84341-2321
(435) 753-2842
Mailing address
139 S 200 W, HYRUM, UT 84319-1241
(435) 245-3348
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1848241205
UT
Other
Enumeration date
08/11/2006
Last updated
07/08/2007
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