Individual
KEVIN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PC
Contact information
Practice address
1403 WALL STREET, CULLMAN, AL 35055-0000
(256) 734-9472
(256) 734-9272
Mailing address
PO BOX 822, CULLMAN, AL 35056-0822
(256) 734-9472
(256) 734-9272
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
00015459
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000086453
—
AL
Enumeration date
01/24/2006
Last updated
09/13/2013
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