Johnson, Jeff
Johnson, Jeff is an individual health care provider with primary practice located at 1903 Broadway St , Paducah KY 42001-7105. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Johnson, Jeff can be contacted via phone (270) 442-1671.Contact Information
Primary practice address
1903 Broadway St
Paducah KY 42001-7105
Phone: (270) 442-1671
Fax: (270) 442-7307
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 15239 | Kentucky |
Profile Details
| NPI number | 1760459440 |
|---|---|
| LBN Legal business name | Johnson, Jeff |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 2nd, 2006 |
| Last updated | Oct 25th, 2007 - about 19 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 | 1760459440 | NPPES |
| Other | 000000044966 | ANTHEM BCBS | |
| MEDICAID | 64152390 | ANTHEM BCBS | |
| MEDICAID | 0040162029 | ANTHEM BCBS |
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