NPI 1093715013

Brent M Johnson, PA

Practitioner Physician Assistant Ludington, MI

Practice location

Address: 5656 W US Highway 10, Ludington, MI 49431-2454
Phone: (231) 843-2543
Fax: (231) 843-2547

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 5601003020 (MI)

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Registry record

NPI: 1093715013
Entity type: Individual
Sex (as registered): Male
NPI issued: 1 Aug 2005
Record last updated: 8 Aug 2016

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.