Individual
MR. KERRY WAYNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
910 HWY 3 WEST, NORMANGEE, TX 77871
(936) 396-2806
(936) 396-9000
Mailing address
910 HWY 3 WEST, NORMANGEE, TX 77871
(936) 396-2806
(936) 396-9000
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G8878
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0975666-01
—
TX
Enumeration date
08/29/2006
Last updated
08/14/2015
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