Provider Demographics
NPI:1891856266
Name:JOHNSON, SARA EMILIE HUSBAND (MD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:EMILIE HUSBAND
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 EAST 4500 SOUTH
Mailing Address - Street 2:SUITE #200
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107
Mailing Address - Country:US
Mailing Address - Phone:801-595-8844
Mailing Address - Fax:801-506-0188
Practice Address - Street 1:495 EAST 4500 SOUTH
Practice Address - Street 2:SUITE #200
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107
Practice Address - Country:US
Practice Address - Phone:801-595-8844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT54137368905208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics