Individual
MR. RICHARD E JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1031 7TH ST NE, DEVILS LAKE, ND 58301
(701) 662-5247
(701) 662-4473
Mailing address
PO BOX 801, DEVILS LAKE, ND 58301
(701) 662-5247
(701) 662-4473
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4523
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10451
—
ND
Enumeration date
07/12/2006
Last updated
10/19/2007
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