| Doctor Name: | DR. BRENT ALAN JOHNSON |
| NPI Number: | 1568458461 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.P.M. |
| License Number: | 5901001757 |
| Business Practice Address: | 3 Msgs/sgcub Elmendorf Afb, AK - 99577 |
| Business Phone Number: | 9372417334 |
| Business Fax Number: | |
| Mailing Address: | 3 Msgs/sgcub, ELMENDORF AFB |
| State: | AK |
| Postal Code: | 99577 |
| Phone Number: | 9372417334 |
| Fax Number: | |
| NPI Enumeration Date: | 09/26/2005 |
| NPI Last Update Date: | 07/18/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 5901001757 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |