Individual
MR. KEITH PATRICK JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
85 HARRISTOWN ROAD, SUITE 103, GLEN ROCK, NJ 07452
(844) 366-8800
(844) 366-8900
Mailing address
85 HARRISTOWN ROAD, SUITE 103, GLEN ROCK, NJ 07452
(844) 366-8800
(844) 366-8900
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
25MA07819000
NJ
207X00000X
Orthopaedic Surgery Physician
Primary
25MA07819000
NJ
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
25MA07819000
NJ
Other
Enumeration date
04/03/2006
Last updated
01/19/2016
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