Individual
MR. BENJAMIN DOUGLAS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, R.T. (R)
Contact information
Practice address
1650 COWLES ST, FAIRBANKS, AK 99701-5907
(907) 458-3900
Mailing address
4311 11TH AVE NE STE 200, SEATTLE, WA 98105-6367
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
1760938021
AK
2085R0202X
Diagnostic Radiology Physician
138210
AK
2085R0203X
Therapeutic Radiology Physician
138210
AK
243U00000X
Radiology Practitioner Assistant
Primary
138210
AK
Other
Enumeration date
09/05/2017
Last updated
10/21/2022
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