Individual
DOUGLAS ALLAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2501 KEENAN DR, INTERNATIONAL FALLS, MN 56649-2181
(218) 293-9431
(218) 285-6875
Mailing address
2501 KEENAN DR, INTERNATIONAL FALLS, MN 56649-2181
(218) 293-9431
(218) 285-6875
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
22875
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
303363500
—
MN
05
—
32404500
—
WI
Enumeration date
07/07/2006
Last updated
05/20/2016
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