NPI 1093415234

Lance Johnson, PAC

Practitioner Physician Assistant Yukon, OK

Practice location

Address: 709 N Czech Hall Rd, Yukon, OK 73099
Phone: (405) 494-8600
Mailing address: PO Box 1867, Bethany, OK 73008-1867

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 5024 (OK)

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Registry record

NPI: 1093415234
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Mar 2023
Record last updated: 7 Mar 2023

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.