Individual
TERRY L JOHANNESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3500 SE FRANK PHILLIPS BLVD, BARTLESVILLE, OK 74006-2300
(918) 331-1104
(918) 331-1446
Mailing address
3450 SE FRANK PHILLIPS BLVD, BARTLESVILLE, OK 74006
(918) 331-2444
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
15864
OK
Other
Enumeration date
05/03/2006
Last updated
12/23/2015
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