Johnson, Kory James
Johnson, Kory James is an individual health care provider with primary practice located at 555 Midtowne St Ne Suite 105, Grand Rapids MI 49503-5729. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery is his primary health care specialty. Johnson, Kory James can be contacted via phone (616) 459-7101.Contact Information
Primary practice address
555 Midtowne St Ne Suite 105
Grand Rapids MI 49503-5729
Phone: (616) 459-7101
Fax: (616) 464-6170
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery | 207XS0114X | 036135656 | Illinois |
| Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery | 207XS0114X | 5101018118 | Michigan |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 5101018118 | Michigan |
Profile Details
| NPI number | 1952539603 |
|---|---|
| LBN Legal business name | Johnson, Kory James |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 1st, 2009 |
| Last updated | Jun 28th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952539603 | NPPES |
| Michigan | Other | OD14869 | MEDICARE GROUP PTAN |
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