Individual
KEVIN K JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 E HAMPDEN AVE, ENGLEWOOD, CO 80113-2702
(303) 761-9190
(720) 874-4462
Mailing address
10800 E GEDDES AVE STE 300, ENGLEWOOD, CO 80112-3895
(303) 761-9190
(720) 874-4462
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
04-36659
KS
2085R0202X
Diagnostic Radiology Physician
17551
HI
2085R0202X
Diagnostic Radiology Physician
25044
NE
2085R0202X
Diagnostic Radiology Physician
Primary
29383
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003135486A
GA MEDICAID
GA
05
—
01293836
—
CO
01
—
02300136
NY MEDICAID
NY
01
—
053221001
TX MEDICAID
TX
05
—
10025709000
—
NE
05
—
1003878448
—
MO
05
—
1003878448
—
MT
05
—
1003878448
—
NV
05
—
1003878448
—
UT
05
—
1003878448
—
WY
01
—
104686220
MI MEDICAID
MI
05
—
1679513196
—
UT
05
—
200425020A
—
KS
05
—
200427030A
—
OK
05
—
2192451
—
LA
01
—
300049154
RR RIA MEDICARE
CO
01
—
300090599
RR MIC MEDICARE
CO
01
—
300090607
RR DIA MEDICARE
CO
05
—
418800
—
AZ
05
—
7617652
—
NC
05
—
84-059792913
—
NE
01
—
P00720354
RR MCR NE
NE
01
—
XPY204569
CA MEDICAID
CA
Enumeration date
04/03/2006
Last updated
03/29/2024
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