Individual
KURT E. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2601 N SPRUCE ST, OGALLALA, NE 69153-2465
(308) 284-3645
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
(602) 495-4577
(602) 417-3549
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14935
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470767637-13
—
NE
Enumeration date
03/24/2006
Last updated
05/02/2011
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