Individual
DR. KYLE J JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
900 WARREN AVE STE 401, EAST PROVIDENCE, RI 02914-1430
(401) 330-2480
(401) 808-6329
Mailing address
900 WARREN AVE STE 401, EAST PROVIDENCE, RI 02914-1430
(401) 330-2480
(401) 808-6329
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO01222
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DO01222
LICENSE
RI
Enumeration date
04/04/2013
Last updated
04/09/2024
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