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NPI Code Detail

MEDICARE: KENNETH H JOHNSON DO

MEDICARE: KENNETH H JOHNSON DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1204D00000XNeuromusculoskeletal Medicine & OMM Physician1437ME
2207Q00000XFamily Medicine Physician1437ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2010211810001OTHERMETRICARE

General Provider Information

NPI Number : 1518929538
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNETH H JOHNSON DO
Provider Business Mailing Address
First Line : 2 HEALTH CENTER DR
Second Line :
City : ATHENS
State : OH
Zip : 45701-2907
Country : US
Telephone Number : 740-593-1660
Fax Number : 740-593-0179
Provider Business Practice Location Address
First Line : 2 HEALTH CENTER DR
Second Line :
City : ATHENS
State : OH
Zip : 45701-2907
Country : US
Telephone Number : 740-593-1660
Fax Number : 740-593-0179
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2006
Last Update Date : 07/20/2016

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Directions to “ KENNETH H JOHNSON DO” Practice Location

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