| Scott William Johnson, | |
|
400 E 3rd St, Duluth, MN 55805-1951 | |
| (218) 786-8364 | |
| Not Available |
| Full Name | Scott William Johnson |
|---|---|
| Gender | Male |
| Speciality | Obstetrics & Gynecology |
| Location | 400 E 3rd St, Duluth, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063445922 | NPI | - | NPPES |
| 936395500 | Medicaid | MN | |
| 31490800 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | 32881 (Minnesota) | Primary |
| 207V00000X | Obstetrics & Gynecology | 14344 (North Dakota) | Secondary |
| Entity Name | Grand Itasca Clinic And Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669426631 PECOS PAC ID: 8123939550 Enrollment ID: O20031105000209 |
| Entity Name | St Lukes Hospital Of Duluth |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902845068 PECOS PAC ID: 7113834839 Enrollment ID: O20031120000212 |
| Entity Name | Douglas County Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164424305 PECOS PAC ID: 0648171413 Enrollment ID: O20040115000387 |
| Entity Name | International Falls Memorial Hospital Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528041183 PECOS PAC ID: 1951365998 Enrollment ID: O20041118000626 |
| Entity Name | Lake Region Healthcare Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093713372 PECOS PAC ID: 3971565334 Enrollment ID: O20060109000246 |
| Entity Name | International Falls Memorial Hospital Association |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1528041183 PECOS PAC ID: 1951365998 Enrollment ID: O20061104000465 |
| Mailing Address | Practice Location Address |
|---|---|
| Scott William Johnson, 400 E 3rd St, Duluth, MN 55805-1951 Ph: (218) 786-8364 | Scott William Johnson, 400 E 3rd St, Duluth, MN 55805-1951 Ph: (218) 786-8364 |
Kirsten Ma Indrelie, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 400 E 3rd St, Duluth, MN 55805 Phone: 218-786-8364 Fax: 504-988-1846 | |
Dr. Andrea R Lays, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 420 E 1st St, Duluth, MN 55805 Phone: 218-786-8364 | |
Haley Marie Meyer, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 400 E 3rd St, Duluth, MN 55805 Phone: 218-786-8364 | |
Aimee Nelson Van Straaten, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1000 E 1st St, Lower Level, Duluth, MN 55805 Phone: 218-722-5148 | |
Kelly Jo Greenleaf, Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 400 E 3rd St, Duluth, MN 55805 Phone: 218-786-3800 | |
William Gary Turner, Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 400 E 3rd St, Duluth, MN 55805 Phone: 218-786-8364 |