Johnson, Kevin M

Johnson, Kevin M is an individual health care provider with primary practice located at 608 Northwest Blvd Suite 301, Coeur D Alene ID 83814-2174. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Johnson, Kevin M can be contacted via phone (208) 676-8346.

Contact Information

Primary practice address
608 Northwest Blvd Suite 301 Coeur D Alene ID 83814-2174
Phone: (208) 676-8346
Fax: (208) 664-5345
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X M7963 Idaho

Profile Details

NPI number 1679685598
LBN Legal business name Johnson, Kevin M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Sep 1st, 2016 - about 10 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 1679685598 NPPES
Idaho MEDICAID 807104000

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