C. Michael Johnson, D.O,Inc.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

1716 Issued in OK

Legal business name

C. MICHAEL JOHNSON, D.O,INC.

Practice address

802 S Jackson Ave
Suite 110
Tulsa, OK 74127-9015

Phone

(918) 587-2389

Fax

(918) 587-4389

NPI assigned

Apr 9, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Susie Monroe

Title

Office Manager

Phone

(918) 587-2389

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226966400000",
    "number": "1679746895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 SO. JACKSON AVE",
            "address_2": "SUITE 110",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741278921",
            "telephone_number": "918-587-2389",
            "fax_number": "918-587-4389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 S JACKSON AVE",
            "address_2": "SUITE 110",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279015",
            "telephone_number": "918-587-2389",
            "fax_number": "918-587-4389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C. MICHAEL JOHNSON, D.O,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-09",
        "last_updated": "2008-11-18",
        "status": "A",
        "authorized_official_last_name": "MONROE",
        "authorized_official_first_name": "SUSIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "918-587-2389",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "OK",
            "license": "1716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100088070 A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Urology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.