Individual
KEITH LELAND JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
551 BREVARD RD, ASHEVILLE, NC 28806-2316
(828) 212-7021
(828) 232-8218
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(239) 432-8331
(813) 321-1296
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-13546
NC
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
01/04/2023
Last updated
09/07/2023
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