Individual
JAMES JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1705 W 2ND ST, ELK CITY, OK 73644-4455
(580) 225-2511
Mailing address
PO BOX 48483, WICHITA, KS 67201-8483
(316) 685-6236
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0082560
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200060570A
—
OK
01
—
53764799001
BCBS
OK
01
—
P00258327
RAILROAD MEDICARE
—
Enumeration date
01/25/2006
Last updated
05/14/2008
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