Provider Demographics
NPI:1609308717
Name:JOHNSON, BRIAN CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:CHRISTOPHER
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 1:110 W 1325 N STE 260
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84721-8101
Mailing Address - Country:US
Mailing Address - Phone:435-586-7676
Mailing Address - Fax:435-586-2290
Practice Address - Street 1:110 W 1325 N STE 260
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84721-8101
Practice Address - Country:US
Practice Address - Phone:435-586-7676
Practice Address - Fax:435-586-2290
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2022-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6435938-1205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine