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NPI Profile for Dr CLARK A JOHNSON in MERIDIAN, ID.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgery, Foot & Ankle |
213ES0103X | 48 | Podiatry |
| NPI Number | 1518225929 |
|
| Status | Active | |
| Credentials | DPM (Doctor of Podiatric Medicine) | |
| Entity | Individual | |
| Enumeration date | 04/24/2012 | |
| Last updated | 02/11/2020 - About 6 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) |
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CLARK A JOHNSON
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CLARK A JOHNSON, DPM