Provider Demographics
NPI:1578666749
Name:JOHNSON, STEVEN ERIC (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:ERIC
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3340 NORTH CENTER ST #800
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-7406
Mailing Address - Country:US
Mailing Address - Phone:801-990-1911
Mailing Address - Fax:801-990-1912
Practice Address - Street 1:3741 W 12600 S
Practice Address - Street 2:RIVERTON HOSPITAL
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84065
Practice Address - Country:US
Practice Address - Phone:801-285-4000
Practice Address - Fax:801-733-5618
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT185554-1205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT266328OtherDESERET MUTUAL
UTPRA02161OtherMOLINA
UTQM0000075886OtherALTIUS
NV0022083381Medicaid
WY118958100Medicaid
UT1502954OtherUMWA
UT2090168OtherUNITED HEALTHCARE
ID003032900Medicaid
UT40211OtherPEHP
AZ825284Medicaid
UT449OtherHEALTHY U
UT870545614JO4OtherEDUCATORS MUTUAL
UT2090168OtherUNITED HEALTHCARE
ID003032900Medicaid
NV0022083381Medicaid