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Individual

DR. KENNETH WAYNE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
1850 BLUEGRASS AVE, LOUISVILLE, KY 40215-1161
(502) 361-6015
(502) 361-6529
Mailing address
226 PAWNEE DR, JEFFERSONVILLE, IN 47130-5245
(812) 288-7767

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
008527
KY
183500000X
Pharmacist
26014524A
IN

Other

Enumeration date
10/19/2007
Last updated
10/19/2007
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