Individual
ANTHONY T JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
102 MANDAN AVE, MANDAN, ND 58554-3771
(701) 667-5000
(701) 323-5709
Mailing address
PO BOX 5501, BISMARCK, ND 58506-5501
(701) 323-6000
(701) 323-5709
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7321
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18610
—
ND
Enumeration date
08/10/2006
Last updated
09/11/2007
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