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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932100039 NPPES
South Carolina MEDICAID 0317PA

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