Individual
STACY A JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
30 N 1900 E, ROOM 5R218, SALT LAKE CITY, UT 84132-0002
(801) 581-7822
(801) 585-9166
Mailing address
30 N 1900 E, ROOM 5R218, SALT LAKE CITY, UT 84132-0002
(801) 581-7822
(801) 585-9166
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
6353729-1205
UT
208M00000X
Hospitalist Physician
Primary
6353729-1205
UT
Other
Enumeration date
04/23/2007
Last updated
10/21/2021
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