Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 10544344-1204 | UT |
NPI | 1124253166 |
---|---|
Provider Name | Dr. Richard Arden Johnson |
First Address | Slc, UT 84127-0128 |
Second Address | Logan, UT 84341 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2009 |
Last Update Date | 25/11/2018 |