Strathmoor Pediatrics

LBN: Dwayne Johnson Md Psc
Strathmoor Pediatrics is an health care organization with primary practice located at 2211 Meadow Dr , Louisville KY 40218-1330. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Dwayne Johnson Md Psc can be contacted via phone (502) 458-2577, or through Johnson, Dwayne Edward via phone (502) 458-2577.

Contact Information

Primary practice address
2211 Meadow Dr Louisville KY 40218-1330
Phone: (502) 458-2577
Fax: (502) 454-0105
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Dwayne Edward Doctor of Medicine (MD)
Phone: (502) 458-2577

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 28666 Kentucky

Profile Details

NPI number 1689701542
LBN Legal business name Dwayne Johnson Md Psc
DBA Doing business as Strathmoor Pediatrics
Authorized official Johnson, Dwayne Edward Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 27th, 2007
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689701542 NPPES
Kentucky MEDICAID 6594322700

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