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Individual

MR. MARC CARL JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
801 E 6TH ST, SUITE 205, PANAMA CITY, FL 32401-3661
(850) 785-3185
(850) 785-6233
Mailing address
801 E 6TH ST, SUITE 205, PANAMA CITY, FL 32401-3661
(850) 785-3185
(850) 785-6233

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9263823
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ARNP9263823
FL STATE LIC
FL
01
G4320
BCBS
FL
Enumeration date
08/14/2007
Last updated
12/12/2007
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