Johnson, Loren Mark

Johnson, Loren Mark is an individual health care provider with primary practice located at 203 W Losey St Suite 1620, Scott Afb IL 62225-5207. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Aerospace Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Johnson, Loren Mark can be contacted via phone (618) 229-6306.

Contact Information

Primary practice address
203 W Losey St Suite 1620 Scott Afb IL 62225-5207
Phone: (618) 229-6306
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0101033282 Virginia
Allopathic & Osteopathic Physicians / Aerospace Medicine 2083A0100X 0101033282 Virginia

Profile Details

NPI number 1114909694
LBN Legal business name Johnson, Loren Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 18th, 2005
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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