Individual
JERIMIAH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1208 W 15TH ST, EDMOND, OK 73013-3001
(405) 340-2100
(405) 340-1184
Mailing address
1208 W 15TH ST, EDMOND, OK 73013-3001
(405) 340-2100
(405) 340-1184
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32698
OK
207Q00000X
Family Medicine Physician
R-10027
IA
Other
Enumeration date
06/20/2014
Last updated
07/21/2022
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