Johnson, Kevin D

Johnson, Kevin D is an individual health care provider with primary practice located at 2609 Electric Ave Ste. A, Port Huron MI 48060-6589. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Johnson, Kevin D can be contacted via phone (810) 982-1300.

Contact Information

Primary practice address
2609 Electric Ave Ste. A Port Huron MI 48060-6589
Phone: (810) 982-1300
Fax: (810) 982-9802
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 4301054492 Michigan

Profile Details

NPI number 1184721599
LBN Legal business name Johnson, Kevin D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Jul 9th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184721599 NPPES
Michigan Other 1807401112 BCBSM
Michigan MEDICAID 2923602 BCBSM
Michigan MEDICAID 3149682 BCBSM

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