Individual
MR. RICKIE E. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
7238 6TH ST BLDG 249, HILL AIR FORCE BASE, UT 84056-5213
(801) 777-1155
(801) 775-6884
Mailing address
500 BROADWAY APT C214, FARMINGTON, UT 84025-5657
(337) 278-8826
(801) 775-6884
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
A10226
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1627755
—
LA
Enumeration date
12/28/2005
Last updated
04/09/2018
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