Kenneth Allan Johnson, MD | |
1601 Fair Rd, Suite 300, Statesboro, GA 30458-1698 | |
(912) 871-6742 | |
(912) 871-2563 |
Full Name | Kenneth Allan Johnson |
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Gender | Male |
Speciality | Orthopaedic Surgery |
Location | 1601 Fair Rd, Statesboro, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1790786820 | NPI | - | NPPES |
00572041A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207X00000X | Orthopaedic Surgery | 037577 (Georgia) | Primary |
Entity Name | Winona Health Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1295789352 PECOS PAC ID: 8527977420 Enrollment ID: O20040106000260 |
Mailing Address | Practice Location Address |
---|---|
Kenneth Allan Johnson, MD 127 Oak Ridge Dr, Statesboro, GA 30458-9135 Ph: (912) 871-6742 | Kenneth Allan Johnson, MD 1601 Fair Rd, Suite 300, Statesboro, GA 30458-1698 Ph: (912) 871-6742 |
Dr. Jordan William Paynter, Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 16915 Highway 67 Ste A, Statesboro, GA 30458 Phone: 912-681-2500 | |
William Stephen Tankersley, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 16915 Highway 67 South, Suite A, Statesboro, GA 30458 Phone: 912-681-2500 Fax: 912-681-2025 | |
Frederick Matthew Laun, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 102 Turkey Trail, Statesboro, GA 30458 Phone: 912-852-5280 Fax: 912-852-9280 |