Individual
CASEY H JOHNSON
Active
Individual
CASEY H JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
40094
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000486192
ANTHEM BLUE CROSS BLUE SH
KY
05
—
64130107
—
KY
Enumeration date
08/22/2006
Last updated
02/10/2023
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