Individual
DR. JUSTIN DALE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1401 HARRODSBURG RD, SUITE C-215, LEXINGTON, KY 40504-3751
(859) 258-6450
(859) 258-6499
Mailing address
1401 HARRODSBURG RD, SUITE C-215, LEXINGTON, KY 40504-3751
(859) 258-6450
(859) 258-6499
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
5815
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5815
TEP
NE
Enumeration date
06/30/2008
Last updated
06/06/2014
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