Johnson, Kenneth Allan
Johnson, Kenneth Allan is an individual health care provider with primary practice located at 1601 Fair Rd Suite 300, Statesboro GA 30458-1698. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Johnson, Kenneth Allan can be contacted via phone (912) 871-6742.Contact Information
Primary practice address
1601 Fair Rd Suite 300
Statesboro GA 30458-1698
Phone: (912) 871-6742
Fax: (912) 871-2563
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 037577 | Georgia |
Profile Details
| NPI number | 1790786820 |
|---|---|
| LBN Legal business name | Johnson, Kenneth Allan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 10th, 2005 |
| Last updated | Jul 7th, 2014 - about 10 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 | 1790786820 | NPPES |
| Georgia | MEDICAID | 00572041A |
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