Individual
BRIAN S JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1532 LONE OAK RD, SUITE 310, PADUCAH, KY 42003-7913
(270) 538-6200
(270) 538-6220
Mailing address
PO BOX 636961, CINCINNATI, OH 45263-6961
(270) 538-6200
(270) 538-6220
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
PA813
KY
363A00000X
Physician Assistant
085-001922
IL
363A00000X
Physician Assistant
PA813
KY
363AM0700X
Medical Physician Assistant
Primary
PA813
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112837
HEALTH ALLIANCE
—
05
—
7100200860
—
KY
Enumeration date
11/21/2006
Last updated
12/04/2020
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