Dr. Jeremiah David Johnson, M.D.
Orthopaedic Surgery, Sports Medicine in Eagan, MN. Individual provider (NPI-1).
NPI number1386031433
StatusActive
Last updated in NPPESAug 19, 2024
Details
- NPI
- 1386031433
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jeremiah David Johnson
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 15, 2015
- Certification date
- Aug 19, 2024
- Last updated
- Aug 19, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207XX0005X | Orthopaedic Surgery, Sports Medicine | 71712 | MN | Yes |
| 207X00000X | Orthopaedic Surgery | 71712 | MN | |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
2700 Vikings CirEagan, MN 55121-1002
Phone 952-456-7600
Mailing address
4200 Dahlberg Dr Ste 300Golden Valley, MN 55422-4841
Phone 952-512-5600 · Fax 952-512-5651
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