Organization
DWAYNE JOHNSON MD PSC
Active
Other names
Strathmoor Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWAYNE EDWARD JOHNSON M.D. (PRESIDENT)
(502) 458-2577
Entity
Organization
Contact information
Practice address
2211 MEADOW DR, LOUISVILLE, KY 40218-1330
(502) 458-2577
(502) 454-0105
Mailing address
2211 MEADOW DR, LOUISVILLE, KY 40218-1330
(502) 458-2577
(502) 454-0105
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
28666
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6594322700
—
KY
Enumeration date
02/27/2007
Last updated
08/22/2020
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