Johnson, Jody Michael

Johnson, Jody Michael is an sole proprietor health care provider with primary practice located at 5000 Ky Route 321 Suite 3141, Prestonsburg KY 41653. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Johnson, Jody Michael can be contacted via phone (606) 889-6240.

Contact Information

Primary practice address
5000 Ky Route 321 Suite 3141 Prestonsburg KY 41653
Phone: (606) 889-6240
Fax: (606) 886-9908
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X 02979 Kentucky
Allopathic & Osteopathic Physicians / Surgery 208600000X 02979 Kentucky

Profile Details

NPI number 1588692503
LBN Legal business name Johnson, Jody Michael
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 29th, 2006
Last updated Feb 3rd, 2021 - about 5 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 1588692503 NPPES
Kentucky MEDICAID 64121213

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