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Individual
KENNETH H JOHNSON
Active
Individual
KENNETH H JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
1437
ME
207Q00000X
Family Medicine Physician
1437
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010211810001
TRICARE
ME
05
—
212530099
—
ME
Enumeration date
04/05/2006
Last updated
07/20/2016
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