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Contact Information

MARK E JOHNSON, MD
1200 SIXTH AVE N
CENTRACARE CLINIC
SAINT CLOUD, MN56303-2735
 Phone: 320-252-5131
 Fax: 320-255-5714
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for MARK E JOHNSON · (Male)

NPI # 1568454502
Status Active
Credentials MD
Entity Individual
Enumeration date 08/16/2005
Last updated 08/26/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • MN License # 33783
  • MN Medicaid 686002800
  • Other 600885 ARAZ GROUP AMERICAS PPO
  • Other 6D71JO BLUE CROSS BLUE SHIELD
  • Other 2114001 FIRST HEALTH PLAN
  • Other HP25456 HEALTH PARTNERS
  • Other 2529937 MEDICA HEALTH PLANS
  • Other 686002800 MEDICAL ASSISTANCE
  • Other 986014 PREFERRED ONE
  • Other 110104487 RR MEDICARE
  • Other 110904 U CARE
Hospital affiliation(s)
  • ST CLOUD HOSPITAL - (Acute Care)
    1406 6TH AVE NORTH
    SAINT CLOUD, MN 56303
  • ST GABRIELS HOSPITAL - (Critical Access)
    815 SOUTHEAST SECOND STREET
    LITTLE FALLS, MN 56345
  • TRI COUNTY HOSPITAL - (Critical Access)
    415 JEFFERSON STREET NORTH
    WADENA, MN 56482
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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