Individual provider · Type 1 NPI
Kenneth Ray Johnson, PA-C
Surgical Physician Assistant · Evans, GA
NPI number
1962784785
Active
Practice location
1203 Town Park Ln
Evans, GA 30809
Fax (706) 922-9168
Mailing address
PO Box 63185
Charlotte, NC 28263-3001
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant | 363AM0700X | 6259 (GA) |
| Surgical Physician Assistant Primary | 363AS0400X | 6259 (GA) |
Surgical Physician Assistant: Definition to come...
3 other providers at this address
Other surgical physician assistant providers in Evans
About NPI 1962784785
Kenneth Ray Johnson, PA-C's National Provider Identifier is 1962784785, issued on Sep 19, 2011. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Evans, GA. The record was last updated on Jun 29, 2018.