Individual
JAIME A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3400 W TECUMSEH RD STE 101, NORMAN, OK 73072-1810
(405) 360-6764
(405) 360-6769
Mailing address
3400 W TECUMSEH RD STE 101, NORMAN, OK 73072-1810
(405) 360-6764
(405) 360-6769
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1198
OK
363AM0700X
Medical Physician Assistant
Primary
1198
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1198
MEDICAL LICENSE
OK
Enumeration date
07/25/2006
Last updated
10/14/2024
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