Provider Demographics
NPI:1538162110
Name:JOHNSON MEDICAL CONSULTING, INC.
Entity type:Organization
Organization Name:JOHNSON MEDICAL CONSULTING, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-250-1999
Mailing Address - Street 1:P.O. BOX 7592
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73506-1592
Mailing Address - Country:US
Mailing Address - Phone:580-250-1999
Mailing Address - Fax:580-355-9533
Practice Address - Street 1:2504 SW LEE BLVD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-8311
Practice Address - Country:US
Practice Address - Phone:580-250-1999
Practice Address - Fax:580-355-9533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK151444332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1233400001Medicare ID - Type Unspecified