Individual
JEFFREY R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1675 WATERTOWER PLACE, SUITE 100, EAST LANSING, MI 48823
(517) 332-0200
(517) 332-0963
Mailing address
1675 WATERTOWER PLACE, SUITE 100, EAST LANSING, MI 48823
(517) 332-0200
(517) 332-0963
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301042405
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3493103
—
MI
Enumeration date
11/07/2005
Last updated
07/12/2007
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