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Individual

KEEGAN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1565 N MAIN ST, STE 406, FALL RIVER, MA 02720-2972
(508) 730-2020
(508) 677-0975
Mailing address
1565 N MAIN ST, STE 406, FALL RIVER, MA 02720-2972
(508) 730-2020
(508) 677-0975

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
D70263
MD
207W00000X
Ophthalmology Physician
Primary
MD13803
RI
208600000X
Surgery Physician
MT188093
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036679000
MD
Enumeration date
01/12/2007
Last updated
01/27/2012
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