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Individual
THOMAS DWAYNE JOHNSON
Active
Individual
THOMAS DWAYNE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37317
KY
208D00000X
General Practice Physician
37317
KY
Other
Enumeration date
07/08/2005
Last updated
01/10/2023
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