# COMMONWEALTH FAMILY PHYSICIANS PSC

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

## Provider details

- **NPI number:** 1821133141
- **Authorized official:** DR. CHARLES CALVIN JOHNSON D.O. (PRESIDENT)
- **Authorized official phone:** (859) 278-8421

## Contact information

- **Practice address:** 1000 MONARCH ST, SUITE 100, LEXINGTON, KY 40513-1899
- **Practice address phone:** (859) 278-8421
- **Practice address fax:** (859) 278-1751
- **Mailing address:** 1000 MONARCH ST, SUITE 100, LEXINGTON, KY 40513-1899
- **Mailing address phone:** (859) 278-8421
- **Mailing address fax:** (859) 278-1751

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 02349 | KY | Yes |

## Other

- **Enumeration date:** 02/21/2007
- **Last updated:** 10/02/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7100244500 | — | KY |