Individual
KEVIN D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 E CLARK BASS BLVD, MCALESTER, OK 74501-4209
(918) 426-1800
(918) 421-8006
Mailing address
1 E CLARK BASS BLVD, MCALESTER, OK 74501-4209
(918) 426-1800
(918) 421-8006
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0032708
OK
Other
Enumeration date
06/27/2006
Last updated
07/08/2007
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