Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 35-04-7132-J | OH |
NPI | 1063414712 |
---|---|
Provider Name | Dr. David Kinnaird Johnson |
First Address | Greenville, OH 45331-1077 |
Second Address | Greenville, OH 45331-1189 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2005 |
Last Update Date | 07/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0576336 | (05) | OH |
C03338 | (02) |