Johnson, Tad Mark

Johnson, Tad Mark is an individual health care provider with primary practice located at 3524 E Milwaukee St , Janesville WI 53546-1626. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy, which is considered as his primary health care specialty. Johnson, Tad Mark can be contacted via phone (608) 756-7100.

Contact Information

Primary practice address
3524 E Milwaukee St Janesville WI 53546-1626
Phone: (608) 756-7100
Fax: (608) 756-4700
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy 207KA0200X 25307 Wisconsin

Profile Details

NPI number 1659339919
LBN Legal business name Johnson, Tad Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Sep 6th, 2012 - about 12 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 1659339919 NPPES
Wisconsin Other JOHNSTAD MERCYCARE INSURANCE
Wisconsin Other 1659339919 MERCYCARE INSURANCE
Wisconsin MEDICAID 1659339919 MERCYCARE INSURANCE
Wisconsin MEDICAID 30661900 MERCYCARE INSURANCE

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