Individual
DR. KEITH R JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D. P.A.
Contact information
Practice address
1300 MURCHISON, SUITE 312, EL PASO, TX 79902
(915) 217-1107
(915) 217-1299
Mailing address
1300 MURCHISON, SUITE 312, EL PASO, TX 79902
(915) 217-1107
(915) 217-1299
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
L4010
TX
207X00000X
Orthopaedic Surgery Physician
L4010
TX
207XP3100X
Pediatric Orthopaedic Surgery Physician
L4010
TX
207XS0106X
Orthopaedic Hand Surgery Physician
L4010
TX
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
L4010
TX
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
L4010
TX
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
L4010
TX
207XX0801X
Orthopaedic Trauma Physician
L4010
TX
208600000X
Surgery Physician
L4010
TX
2086S0127X
Trauma Surgery Physician
L4010
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151853205
—
TX
01
—
8F20596
INDIVIDUAL PTAN
TX
Enumeration date
07/08/2005
Last updated
03/07/2017
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