Organization
COMMONWEALTH FAMILY PHYSICIANS PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES CALVIN JOHNSON D.O. (PRESIDENT)
(859) 278-8421
Entity
Organization
Contact information
Practice address
1000 MONARCH ST, SUITE 100, LEXINGTON, KY 40513-1899
(859) 278-8421
(859) 278-1751
Mailing address
1000 MONARCH ST, SUITE 100, LEXINGTON, KY 40513-1899
(859) 278-8421
(859) 278-1751
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02349
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100244500
—
KY
Enumeration date
02/21/2007
Last updated
10/02/2013
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