Individual
RUTH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
500 CIMARRON DR, BOX 323, MANNFORD, OK 74044-9504
(918) 865-5000
(918) 865-5050
Mailing address
500 CIMARRON DR, BOX 323, MANNFORD, OK 74044-9504
(918) 865-5000
(918) 865-5050
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-1777
OK
Other
Enumeration date
10/13/2006
Last updated
03/05/2009
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