Individual
DR. JOHN R. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
95 BRYAN BLVD, CORBIN, KY 40701-2788
(606) 526-4590
(606) 526-0548
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(502) 489-5730
(502) 489-5753
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21412
KY
2083X0100X
Occupational Medicine Physician
21412
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21412
KY LIC#
KY
Enumeration date
11/10/2006
Last updated
03/07/2023
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