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DR. TAD MARK JOHNSON MD

Allergy

Janesville, Wisconsin

Provider NPI: 1659339919

Provider Information:
DR. TAD MARK JOHNSON MD


Practice Location:
3524 E MILWAUKEE ST  JANESVILLE, WI 53546 US
Tel: 608-756-7100  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207KA0200XPhysicians
Allergy & Immunology
Allergy
WI25307

Other Provider Identifiers:

IssuerNumberStateType
MERCYCARE INSURANCEJOHNSTADWI01
BCBSWI1659339919WI01
30661900WI05
1659339919WI05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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