Individual
MARY J JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1919 LATHROP ST, FAIRBANKS, AK 99701-5937
(907) 458-2619
(907) 374-1089
Mailing address
PO BOX 73720, FAIRBANKS, AK 99707-3720
(907) 458-2619
(907) 374-1089
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
111064
AK
207Q00000X
Family Medicine Physician
111064
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1652171
—
AK
Enumeration date
06/07/2013
Last updated
10/20/2025
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