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:
Health care specialties
| Specialty | Code | License # | 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 2 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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