Johnson, Judith L

Johnson, Judith L is an individual health care provider with primary practice located at 1000 E 1St St Suite Ll, Duluth MN 55805-2297. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Johnson, Judith L can be contacted via phone (218) 722-5629.

Contact Information

Primary practice address
1000 E 1St St Suite Ll Duluth MN 55805-2297
Phone: (218) 722-5629
Fax: (218) 722-5148
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 40719 Minnesota

Profile Details

NPI number 1033188347
LBN Legal business name Johnson, Judith L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2006
Last updated Jul 8th, 2007 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1033188347 NPPES
Other 01017175 PREFERRED ONE
Other 31B35JO PREFERRED ONE
Other A011 PREFERRED ONE
MEDICAID 199824200 PREFERRED ONE
Other 123030 PREFERRED ONE
MEDICAID 32459800 PREFERRED ONE
Other HP26562 PREFERRED ONE
Other 0708040 PREFERRED ONE

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