Individual
AMY O JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
911 BYPASS RD BLDG A, PIKEVILLE, KY 41501-1689
(606) 430-2205
(606) 218-7507
Mailing address
PO BOX 432, PIKEVILLE, KY 41502-0432
(606) 430-2205
(606) 218-7507
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2002-00267
NC
208600000X
Surgery Physician
Primary
44838
KY
2086S0129X
Vascular Surgery Physician
230012
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100195700
—
KY
05
—
89126X4
—
NC
Enumeration date
06/16/2005
Last updated
09/22/2022
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