Richard Bart Johansen, MD
Emergency Medicine in West Jordan, UT. Individual provider (NPI-1).
NPI number1144281114
StatusActive
Last updated in NPPESNov 8, 2022
Details
- NPI
- 1144281114
- Entity type
- Individual (NPI-1)
- Name
- Richard Bart Johansen
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 30, 2006
- Certification date
- Nov 8, 2022
- Last updated
- Nov 8, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | 184747-1205 | UT | Yes |
| 207PE0004X | Emergency Medicine, Emergency Medical Services | 184747-1205 | UT |
Practice location
3580 W 9000 SWest Jordan, UT 84088-8812
Phone 801-561-8888
Mailing address
144 S 500 E2nd Floor
Salt Lake City, UT 84102-1907
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