Individual
DR. CHARLES C JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1000 MONARCH ST, STE 100, LEXINGTON, KY 40513
(859) 278-8421
(859) 278-1751
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7818
(606) 330-7825
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02349
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64023492
—
KY
Enumeration date
09/25/2006
Last updated
08/02/2019
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