| J Kevin Johnson Md Pc | |
|
1600 North Grand Suite 520 Pueblo CO 81003 | |
| (719) 542-3100 | |
| (719) 542-3100 |
| Full Name | J Kevin Johnson Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1600 North Grand, Pueblo, Colorado |
| Authorized Official Name and Position | J Kevin Johnson (DOCTOR) |
| Authorized Official Contact | 7195423100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J Kevin Johnson Md Pc 1600 North Grand Suite 520 Pueblo CO 81003 Ph: (719) 542-3100 | J Kevin Johnson Md Pc 1600 North Grand Suite 520 Pueblo CO 81003 Ph: (719) 542-3100 |
| NPI Number | 1376659805 |
|---|---|
| Provider Enumeration Date | 08/21/2006 |
| Last Update Date | 06/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376659805 | NPI | - | NPPES |
| 01365246 | Medicaid | CO | |
| DD7190 | Other | CO | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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