Individual
MARK JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
385 MAIN ST SOUTH, UNION SQUARE, SOUTHBURY, CT 06488
(203) 264-7999
(203) 264-7477
Mailing address
385 MAIN ST SOUTH, UNION SQUARE BLDG #1, SOUTHBURY, CT 06488
(203) 264-7999
(203) 264-7477
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
Primary
022134
CT
2085R0202X
Diagnostic Radiology Physician
022134
CT
2085U0001X
Diagnostic Ultrasound Physician
022134
CT
Other
Enumeration date
07/10/2006
Last updated
09/11/2025
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