Individual
DR. KORY JAMES JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1111 LEFFINGWELL AVE NE, GRAND RAPIDS, MI 49525-6406
(616) 459-7101
Mailing address
1111 LEFFINGWELL AVE NE, GRAND RAPIDS, MI 49525-6406
(616) 459-7101
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
5101018118
MI
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
5101018118
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OD14869
MEDICARE GROUP PTAN
MI
Enumeration date
07/01/2009
Last updated
04/07/2025
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