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General NPI Number Information
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NPI Number | 1891798682
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Entity Type | Individual
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Provider Name | WILLIAM KENT JOHNSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 511 OAKWOOD BLVD STE 150
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City | ROUND ROCK
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State | TX
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Zip | 78681-4068
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Country | US
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Telephone | 248-629-2176
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Fax | 248-856-4704
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Provider Business Mailing Address
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Address Line | 7125 ORCHARD LAKE RD STE 210
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-3618
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Country | US
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Telephone | 248-629-2176
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Fax | 248-856-4704
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | H6320
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | H6320
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License Number State | TX
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