Dr. Carl M Johnson
Cardiothoracic Vascular Surgeon
2601 Kentucky Ave Ste 300
Paducah
, Kentucky 42003-3826
Dr. Carl M Johnson
Cardiothoracic Vascular Surgeon
2601 Kentucky Ave Ste 300
Paducah
, Kentucky 42003-3826
(270) 575-8359
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About
Features
Specialties
- Cardiothoracic Vascular Surgeon
Languages spoken
- English
Location
First Address
- Dr. Carl M Johnson
- 2601 Kentucky Ave Ste 306
- Paducah, KY
- Zip : 42003-3817
- Fax : (270) 575-8359
- Phone : (270) 415-7653
Second Address
- Dr. Carl M Johnson
- 2601 Kentucky Ave Ste 300
- Paducah, KY
- Zip : 42003-3826
- Fax : (270) 443-5549
- Phone : (270) 443-5564
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208G00000X | Cardiothoracic Vascular Surgeon | 24921 | KY |
National Provider Identifier
| NPI | 1073519070 |
|---|---|
| Provider Name | Dr. Carl M Johnson |
| First Address | Paducah, KY 42003-3817 |
| Second Address | Paducah, KY 42003-3826 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/06/2005 |
| Last Update Date | 04/12/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 64249212 | (05) | KY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.