Kevin Russell Johnson in Dallas - Physician Assistant
Kevin Russell Johnson - NPI 1194745877
Kevin Russell Johnson is a Physician Assistant in Dallas, Texas. Kevin Russell Johnson practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Kevin Russell Johnson is 1194745877. The last update date is 2023-03-07.
Kevin Russell Johnson's current location address is 5541 Goodwin Ave, Dallas, Texas. You can contact this provider via phone number 8173430431. The mailing address for Kevin Russell Johnson is 5541 Goodwin Ave, Dallas, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kevin Russell Johnson |
|---|---|
| Address | 5541 Goodwin Ave, Dallas, Texas |
| Phone Number | 8173430431 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1194745877 |
|---|---|
| Provider Enumeration Date | 2006-07-19 |
| Last Updated Date | 2023-03-07 |
Provider Mailing Address Detail
| Address | 5541 Goodwin Ave |
|---|---|
| City | Dallas |
| State | Texas (TX) |
| Post Code | 752066212 |
| Phone Number | 8173430431 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA04026 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| PA04026 | TX | STATE LICENSE # | |
| Y0133663 | TX | TX DPS # |
Post Comment/ Review Below
What is the Kevin Russell Johnson's 1194745877?
The Kevin Russell Johnson's NPI (National Provider Identifier) Number is 1194745877. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Kevin Russell Johnson?
The Kevin Russell Johnson is physically situated at 5541 Goodwin Ave, in the city of Dallas, state of TX, with the postal code 752066212.
What is the Kevin Russell Johnson's specialty and taxonomy code?
The Kevin Russell Johnson's specialty is Physician Assistant, and the corresponding taxonomy code is 363A00000X.
What is the area of specialization for Kevin Russell Johnson, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Kevin Russell Johnson is Physician Assistant, and the corresponding taxonomy code that categorizes this area of expertise is 363A00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1194745877 to Kevin Russell Johnson?
The Kevin Russell Johnson received its 1194745877 assignment from the Centers for Medicare & Medicaid Services on 2006-07-19.
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