Individual
LARRY WAYNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1015 GARDEN LAKE PKWY, TOLEDO, OH 43614-2779
(419) 383-5500
(419) 383-5575
Mailing address
1015 GARDEN LAKE PKWY, TOLEDO, OH 43614-2779
(419) 383-5500
(419) 383-5575
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35043619
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0418793
—
OH
Enumeration date
12/01/2005
Last updated
02/15/2012
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