Individual
JEREMY J JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
920 STANTON L YOUNG BLVD # 2140, OKLAHOMA CITY, OK 73104-5020
(405) 271-6308
Mailing address
920 STANTON L YOUNG BLVD # 2140, OKLAHOMA CITY, OK 73104-5020
(405) 271-6308
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
26424
OK
208600000X
Surgery Physician
Primary
E-17099
AR
2086S0120X
Pediatric Surgery Physician
E-17099
AR
Other
Enumeration date
06/12/2008
Last updated
09/29/2023
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