Johnson, Kevin Raymond

Johnson, Kevin Raymond is an individual health care provider with primary practice located at 1510 Division St Ste 210, Oregon City OR 97045-1599. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery, Allopathic & Osteopathic Physicians / Colon & Rectal Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Johnson, Kevin Raymond can be contacted via phone (503) 723-6525.

Contact Information

Primary practice address
1510 Division St Ste 210 Oregon City OR 97045-1599
Phone: (503) 723-6525
Fax: (503) 723-6508
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD16564 Oregon
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X MD16564 Oregon
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X MD16564 Oregon

Profile Details

NPI number 1750387049
LBN Legal business name Johnson, Kevin Raymond
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2005
Last updated Jun 27th, 2011 - about 13 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 1750387049 NPPES
Oregon MEDICAID 128541
Oregon Other P00924574

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