# CRAIG A. JOHNSON, M.D., PSC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447473392
- **Authorized official:** OPAL R BOONE (PRACTICE MANAGER)
- **Authorized official phone:** (270) 259-9316

## Contact information

- **Practice address:** 912 WALLACE AVE, SUITE 101, LEITCHFIELD, KY 42754-2404
- **Practice address phone:** (270) 259-9316
- **Practice address fax:** (270) 259-6571
- **Mailing address:** 912 WALLACE AVE, SUITE 101, LEITCHFIELD, KY 42754-2404
- **Mailing address phone:** (270) 259-9316
- **Mailing address fax:** (270) 259-6571

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207VH0002X | Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician | KY23893 | KY | Yes |

## Other

- **Enumeration date:** 04/10/2007
- **Last updated:** 08/22/2020