Individual
DR. BROCK A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1729 KINNEYS LN STE 102, PORTSMOUTH, OH 45662-3166
(740) 351-0980
(740) 351-0021
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 408-9565
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
35.139825
OH
207X00000X
Orthopaedic Surgery Physician
54062
KY
Other
Enumeration date
05/06/2014
Last updated
09/02/2020
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