Individual
KENNETH THOMAS JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
151 FARMINGTON AVE, HARTFORD, CT 06156-0001
(860) 636-9073
Mailing address
51 BERKSHIRE DR, FARMINGTON, CT 06032-2505
(860) 636-9073
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
80902
MA
Other
Enumeration date
05/26/2006
Last updated
07/08/2007
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