Individual
KENNETH LEE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 DOCTORS DR, SUITE N, KINSTON, NC 28501-1584
(252) 559-2200
(252) 522-9778
Mailing address
701 DOCTORS DR, SUITE N, KINSTON, NC 28501-1584
(252) 559-2200
(252) 522-9778
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9801319
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110208101
RAILROAD MEDICARE
—
05
—
891263G
—
NC
Enumeration date
12/08/2005
Last updated
01/10/2022
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