NPI 1033146212

Jesse Clark Johnson, MD

Practitioner Diagnostic Radiology Physician Traverse City, MI

Practice location

Address: 1105 Sixth St, Traverse City, MI 49684-2345
Phone: (231) 935-0497
Mailing address: PO Box 30516 Dept. 9516, Lansing, MI 48909

Registered specialties

Diagnostic Radiology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2085R0202X Licence 4301078527 (MI)

Other Radiology providers in Michigan →

Registry record

NPI: 1033146212
Entity type: Individual
Sex (as registered): Male
NPI issued: 26 Jun 2006
Record last updated: 29 Apr 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.