Individual provider · Type 1 NPI

Mark Haley Johnson, IDC

Independent Duty Corpsman · Groton, CT

NPI number 1710199666 Active

Practice location

Nlon Medical Department Bldg 76, Naval Submarine Base
Groton, CT 06340

Call (860) 694-2795 Map

Fax (860) 694-4326

Mailing address

197 Charter Oak Dr
Groton, CT 06340

Specialties and licenses

TaxonomyCodeLicense
Independent Duty Corpsman Primary 1710I1002XNone listed

Independent Duty Corpsman: A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and othe…

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About NPI 1710199666

Mark Haley Johnson, IDC's National Provider Identifier is 1710199666, issued on May 4, 2007. The primary taxonomy on file is Independent Duty Corpsman (1710I1002X), and the practice location is in Groton, CT. The record was last updated on May 6, 2011.