Johnson, Clarence Michael

Johnson, Clarence Michael is an individual health care provider with primary practice located at 802 S Jackson Ave Suite 110, Tulsa OK 74127-9015. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Johnson, Clarence Michael can be contacted via phone (918) 599-4477.

Contact Information

Primary practice address
802 S Jackson Ave Suite 110 Tulsa OK 74127-9015
Phone: (918) 599-4477
Fax: (918) 599-4479
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 1716 Oklahoma

Profile Details

NPI number 1013937713
LBN Legal business name Johnson, Clarence Michael
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2006
Last updated Jul 13th, 2012 - about 14 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 1013937713 NPPES
Oklahoma MEDICAID 100088070A

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