Individual
SUSAN R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 335-3210
(319) 335-3560
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 335-3210
(319) 335-3560
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
20693
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0169615
—
IA
01
—
16961
WELLMARK BCBS
IA
Enumeration date
10/06/2005
Last updated
12/11/2007
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