Johnson, Judith L
Johnson, Judith L is an individual health care provider with primary practice located at 1000 E 1St St Suite Ll, Duluth MN 55805-2297. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Johnson, Judith L can be contacted via phone (218) 722-5629.Contact Information
Primary practice address
1000 E 1St St Suite Ll
Duluth MN 55805-2297
Phone: (218) 722-5629
Fax: (218) 722-5148
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 40719 | Minnesota |
Profile Details
| NPI number | 1033188347 |
|---|---|
| LBN Legal business name | Johnson, Judith L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 17th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1033188347 | NPPES |
| Other | 01017175 | PREFERRED ONE | |
| Other | 31B35JO | PREFERRED ONE | |
| Other | A011 | PREFERRED ONE | |
| MEDICAID | 199824200 | PREFERRED ONE | |
| Other | 123030 | PREFERRED ONE | |
| MEDICAID | 32459800 | PREFERRED ONE | |
| Other | HP26562 | PREFERRED ONE | |
| Other | 0708040 | PREFERRED ONE |
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