Johnson, Kyle Harris
Johnson, Kyle Harris is an individual health care provider with primary practice located at 1910 Blanding St , Columbia SC 29201-3520. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Johnson, Kyle Harris can be contacted via phone (803) 256-4107.Contact Information
Primary practice address
1910 Blanding St
Columbia SC 29201-3520
Phone: (803) 256-4107
Fax: (803) 253-6655
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 1014 | South Carolina |
Profile Details
| NPI number | 1932100039 |
|---|---|
| LBN Legal business name | Johnson, Kyle Harris |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 10th, 2005 |
| Last updated | Oct 15th, 2007 - about 17 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 | 1932100039 | NPPES |
| South Carolina | MEDICAID | 0317PA |
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