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Blake A Johnson, MD
Diagnostic Radiology Physician in St Louis Park, Minnesota
NPI 1811964174

Blake A Johnson is a Diagnostic Radiology Physician based in Minneapolis, MN and is specialized in Diagnostic Radiology. Blake A Johnson practices in St Louis Park, MN and has the professional credentials of MD. The NPI Number for Blake A Johnson is 1811964174 and holds a License No. 39490 (Minnesota).

The current practice location address for Blake A Johnson is 5775 Wayzata Blvd, St Louis Park, MN and can be reached out via phone at 952-541-1840 and via fax at 952-513-6880.

Location: 5775 Wayzata Blvd, St Louis Park, MN, 55485-6035
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1811964174
Provider Name
Blake A Johnson
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
5775 Wayzata Blvd, St Louis Park, MN, 55485-6035
Phone Number
952-541-1840
Fax Number
952-513-6880
Provider Enumeration Date
03/07/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
205022600 05 MN
institution
Provider Business Practice Location Address Details
Address
5775 Wayzata Blvd
City
St Louis Park
State
Minnesota
Zip
55416
Phone Number
952-541-1840
Fax Number
952-513-6880
person
Provider Business Mailing Address Details
Address
5775 Wayzata Blvd
City
St Louis Park
State
Minnesota
Zip
55416
Phone Number
952-541-1840
Fax Number
952-513-6880
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
39490 (Minnesota)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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