Johnsen, Gregory D
Johnsen, Gregory D is an individual health care provider with primary practice located at 1265 S Utica Ave Suite 300, Tulsa OK 74104-4243. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Johnsen, Gregory D can be contacted via phone (918) 592-0999.Contact Information
Primary practice address
1265 S Utica Ave Suite 300
Tulsa OK 74104-4243
Phone: (918) 592-0999
Fax: (918) 592-1021
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 16972 | Oklahoma |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 16972 | Oklahoma |
Profile Details
| NPI number | 1710957105 |
|---|---|
| LBN Legal business name | Johnsen, Gregory D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 26th, 2006 |
| Last updated | Mar 4th, 2014 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710957105 | NPPES |
| Oklahoma | Other | 110104903 | MEDICARE RAILROAD |
| Oklahoma | Other | OK400770 | MEDICARE RAILROAD |
| Oklahoma | Other | P00611405 | MEDICARE RAILROAD |
| Oklahoma | MEDICAID | 100254430A | MEDICARE RAILROAD |
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