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Organization

C. MICHAEL JOHNSON, D.O,INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SUSIE MONROE (OFFICE MANAGER)
(918) 587-2389
Entity
Organization

Contact information

Practice address
802 S JACKSON AVE, SUITE 110, TULSA, OK 74127-9015
(918) 587-2389
(918) 587-4389
Mailing address
802 SO. JACKSON AVE, SUITE 110, TULSA, OK 74127-8921
(918) 587-2389
(918) 587-4389

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
1716
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100088070 A
OK
Enumeration date
04/09/2008
Last updated
11/18/2008
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