Johnson, Jody Michael
Johnson, Jody Michael is an sole proprietor health care provider with primary practice located at 5000 Ky Route 321 Suite 3141, Prestonsburg KY 41653. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Johnson, Jody Michael can be contacted via phone (606) 889-6240.Contact Information
Primary practice address
5000 Ky Route 321 Suite 3141
Prestonsburg KY 41653
Phone: (606) 889-6240
Fax: (606) 886-9908
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207QA0401X | 02979 | Kentucky |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 02979 | Kentucky |
Profile Details
| NPI number | 1588692503 |
|---|---|
| LBN Legal business name | Johnson, Jody Michael |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 29th, 2006 |
| Last updated | Feb 3rd, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588692503 | NPPES |
| Kentucky | MEDICAID | 64121213 |
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