Johnson, Carl M

Johnson, Carl M is an individual health care provider with primary practice located at 2601 Kentucky Ave Ste 300, Paducah KY 42003-3826. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Johnson, Carl M can be contacted via phone (270) 443-5564.

Contact Information

Primary practice address
2601 Kentucky Ave Ste 300 Paducah KY 42003-3826
Phone: (270) 443-5564
Fax: (270) 443-5549
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 24921 Kentucky

Profile Details

NPI number 1073519070
LBN Legal business name Johnson, Carl M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2005
Last updated Dec 4th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073519070 NPPES
Kentucky MEDICAID 64249212

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