Individual
DR. CAROL J. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-3300
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(651) 245-1130
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
45735
MN
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
15917
ND
207QG0300X
Geriatric Medicine (Family Medicine) Physician
45749
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-18712
MEDICA
MN
01
—
072K4J0
BLUE CROSS
MN
01
—
171680
UCARE MINNESOTA
MN
01
—
1882619
AMERICA'S PPO
MN
01
—
2110090
FIRST HEALTH GROUP
MN
05
—
34407600
—
WI
01
—
607632700
GROUP HEALTH EAU CLAIRE
MN
05
—
607632700
—
MN
01
—
66-06190
MEDICA URGENT CARE
MN
01
—
HP38799
HEALTH PARTNERS
MN
01
—
NA9141035345
PREFERRED ONE
MN
01
—
P00047499
RAILROAD MEDICARE
MN
Enumeration date
04/03/2006
Last updated
10/20/2021
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