Individual
MICHAEL SHANE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13600 PRAIRIE VIEW LN, OKLAHOMA CITY, OK 73142-5917
(888) 330-7831
Mailing address
13600 PRAIRIE VIEW LN, OKLAHOMA CITY, OK 73142-5917
(888) 330-7831
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
30380
OK
Other
Enumeration date
06/03/2011
Last updated
04/01/2014
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