Mark Dale Johnson
Medical Specialty
Professional ID
- NPI: 1184668659
- PECOS ID: 6406872803
- Enrollment ID: I20051014000515
- Credential(MD, DO, DPM): MD
- Medical School: University Of Utah School Of Medicine
- Medical School Graduation Year: 1989
Hospital Service
- Hospital CCN1: 460010
- Business Name (LBN)1: Intermountain Medical Center
- Hospital CCN2: 460049
- Business Name (LBN)2: The Orthopedic Specialty Hospital
- Hospital CCN3: 460047
- Business Name (LBN)3: St Marks Hospital
Medical Practices
- Organization Name: Jordan Ridge Family Medicine Pllc
- Group Practice ID assigned by PECOS: 8820091473
- Number of Group Practice member: 3
Location
- Address1: 6321 S Redwood Rd
- Address2: Suite 201
- City: Salt Lake City
- State: Utah
- Zip Code: 84123
- Phone Number: (801)265-2212
Medicare
- Medicare Assignment: Yes
- Report Quality of Care to Physician Quality Reporting System (PQRS): Yes
- Used Electronic health record (EHR):