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Individual

DR. KEVIN JOHNSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
559 W WASHINGTON ST, BURNS, OR 97720-1441
(541) 573-2074
(541) 573-8893
Mailing address
559 W WASHINGTON ST, BURNS, OR 97720-1441
(541) 573-2074
(541) 573-8893

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD23974
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
286617
OR
01
838331003
BLUE CROSS BLUE SHIELD
OR
01
P00163103
RAILROAD MEDICARE
OR
Enumeration date
07/24/2006
Last updated
02/06/2014
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