Individual
DR. WILLIS BRADLEY JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
701 NE 10TH ST, OKLAHOMA CITY, OK 73104-5403
(405) 280-5550
Mailing address
701 NE 10TH ST, OKLAHOMA CITY, OK 73104-5403
(405) 280-5550
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
132
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100780620A
—
OK
Enumeration date
02/27/2006
Last updated
05/02/2014
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