Johnson, Gary Blake

Johnson, Gary Blake is an individual health care provider with primary practice located at 24 S 1100 E Ste 105 , Salt Lake City UT 84102-1593. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Urology. Allopathic & Osteopathic Physicians / Urology is his primary health care specialty. Johnson, Gary Blake can be contacted via phone (801) 965-3600.

Contact Information

Primary practice address
24 S 1100 E Ste 105 Salt Lake City UT 84102-1593
Phone: (801) 965-3600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 5860718-1205 Utah
Allopathic & Osteopathic Physicians / Urology 208800000X 5860718-1205 Utah

Profile Details

NPI number 1144223827
LBN Legal business name Johnson, Gary Blake
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2005
Last updated Feb 7th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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