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General NPI Number Information
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NPI Number | 1679891543
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Entity Type | Organization
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Legal Business Name | DR THOMAS D JOHNSON PLLC
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Dates
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Enumeration Date | 05/17/2010
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Last Update Date | 01/14/2014
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Provider Practice Location Address
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Address Line | 532 N BARDSTOWN RD
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City | MT WASHINGTON
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State | KY
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Zip | 40047
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Country | US
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Telephone | 502-538-4800
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Fax |
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Provider Business Mailing Address
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Address Line | 532 N BARDSTOWN RD
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City | MT WASHINGTON
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State | KY
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Zip | 40047
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Country | US
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Telephone | 502-538-4800
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | THOMAS D JOHNSON
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Credential | MD
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Telephone | 502-538-4800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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