Individual
DR. KENT D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5908 S 142ND ST, OMAHA, NE 68137-2800
(402) 354-1900
(402) 354-1910
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-2155
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14442
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720194327
—
IA
05
—
47068731706
—
NE
05
—
47068731798
—
NE
Enumeration date
08/23/2006
Last updated
12/20/2013
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