Johnson, Kenneth M

Johnson, Kenneth M is an individual health care provider with primary practice located at 1726 Shawano Ave , Green Bay WI 54303-3216. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Johnson, Kenneth M can be contacted via phone (414) 290-6720.

Contact Information

Primary practice address
1726 Shawano Ave Green Bay WI 54303-3216
Phone: (414) 290-6720
Fax: (414) 290-6755
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036-078597 Illinois
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 53595-020 Wisconsin

Profile Details

NPI number 1366486458
LBN Legal business name Johnson, Kenneth M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Dec 20th, 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1366486458 NPPES
Wisconsin Other 930106598 MEDICARE RAILROAD
Wisconsin Other 930080950 MEDICARE RAILROAD
Wisconsin MEDICAID 104161654 MEDICARE RAILROAD
Wisconsin Other 010056900 MEDICARE RAILROAD
Wisconsin Other 930079989 MEDICARE RAILROAD
Wisconsin MEDICAID 32019000 MEDICARE RAILROAD
Wisconsin Other 930070593 MEDICARE RAILROAD
Wisconsin Other 930077765 MEDICARE RAILROAD

Popular Providers