Individual
THOMAS WILLIAM JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
419 W WACKERLY ST, MIDLAND, MI 48640-2761
(989) 631-5721
(989) 631-9919
Mailing address
419 W WACKERLY ST, MIDLAND, MI 48640-2761
(989) 631-5721
(989) 631-9919
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301050657
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160023011
RAILROAD MEDICARE
MI
01
—
160E610010
BLUE CROSS BLUE SHIELD
MI
05
—
1901001
—
MI
Enumeration date
10/18/2006
Last updated
01/12/2016
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