NPI 1518225929

Clark a Johnson, DPM

Practitioner Foot & Ankle Surgery Podiatrist Meridian, ID

Practice location

Address: 3120 W Belltower Dr STE 100, Meridian, ID 83646-7744
Phone: (208) 516-3617
Fax: (208) 314-2029

Registered specialties (2)

Foot & Ankle Surgery Podiatrist Primary

Podiatric Medicine & Surgery Service Providers Taxonomy 213ES0103X Licence P242 (ID)

Other Podiatrist providers in Idaho →

Foot & Ankle Surgery Podiatrist

Podiatric Medicine & Surgery Service Providers Taxonomy 213ES0103X Licence POD.0000757 (CO)

Registry record

NPI: 1518225929
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Apr 2012
Record last updated: 11 Feb 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.