Individual
IAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
307 BOATNER RD, EGLIN AFB, FL 32542-1302
(801) 326-3567
Mailing address
307 BOATNER RD STE 114, EGLIN AFB, FL 32542-1302
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OP61190273
WA
Other
Enumeration date
03/23/2020
Last updated
07/12/2024
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