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Individual

KEVIN EARL JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1120 GREENE ST, ADEL, IA 50003-1712
(515) 993-4656
(515) 993-4532
Mailing address
PO BOX 674721, DALLAS, TX 75267-4721
(515) 643-2519
(515) 993-4532

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
134561
IA

Other

Enumeration date
04/03/2025
Last updated
11/19/2025
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