Johnson, Brent M

Johnson, Brent M is an individual health care provider with primary practice located at 5656 W Us Highway 10 , Ludington MI 49431-2454. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Johnson, Brent M can be contacted via phone (231) 843-2543.

Contact Information

Primary practice address
5656 W Us Highway 10 Ludington MI 49431-2454
Phone: (231) 843-2543
Fax: (231) 843-2547
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601003020 Michigan

Profile Details

NPI number 1093715013
LBN Legal business name Johnson, Brent M
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2005
Last updated Aug 8th, 2016 - about 10 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 1093715013 NPPES
Michigan Other CJ0662 MEDICARE RAILROAD
Michigan Other 5601003020 MEDICARE RAILROAD

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