Individual
JORGE HOWARD JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
113 COMANCHE RD, FORT MEADE, SD 57741-1002
(605) 720-7145
Mailing address
20492 CROOK MOUNTAIN RD, WHITEWOOD, SD 57793-3015
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
1581
SD
Other
Enumeration date
12/05/2006
Last updated
07/08/2007
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