| Doctor Name: | GARY B JOHNSON |
| NPI Number: | 1679673321 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D., MPH, FACOEM |
| License Number: | 30125 |
| Business Practice Address: | 5100 Gamble Dr. Suite 100 Mail Stop 31200a, Healthpartners West Clinic St. Louis Park, MN - 554161582 |
| Business Phone Number: | 9525412500 |
| Business Fax Number: | 9525956455 |
| Mailing Address: | 8170 33rd Ave S, Ms 21110q MINNEAPOLIS |
| State: | MN |
| Postal Code: | 554254516 |
| Phone Number: | 9528835375 |
| Fax Number: | 9525956455 |
| NPI Enumeration Date: | 09/23/2006 |
| NPI Last Update Date: | 12/23/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2083P0500X |
| License Number: | 30125 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Preventive Medicine |
| Taxonomy Specialization: | Preventive Medicine/Occupational Environmental Medicine |
| Taxonomy Definition: | A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. |