Individual
DR. JUSTIN R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 269-5908
Mailing address
1601 W CONEFLOWER DR, #4212, PEORIA, IL 61615-7437
(309) 269-5908
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-126238
IL
207P00000X
Emergency Medicine Physician
125054592
IL
Other
Enumeration date
06/19/2008
Last updated
05/02/2023
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