Johnson, Kelly A.

Johnson, Kelly A. is an individual health care provider with primary practice located at 6403 Malcolm Dr , Dallas TX 75214-3104. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Johnson, Kelly A. can be contacted via phone (214) 914-2480.

Contact Information

Primary practice address
6403 Malcolm Dr Dallas TX 75214-3104
Phone: (214) 914-2480
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X N8669 Texas

Profile Details

NPI number 1346246386
LBN Legal business name Johnson, Kelly A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2005
Last updated Mar 22nd, 2016 - about 8 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 1346246386 NPPES
Ohio MEDICAID 2461803

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