Dwayne Johnson MD Psc
NPI #1689701542 in Louisville, Kentucky
Provider Information
- NPI Number
- 1689701542
- Entity Type
- Organization
- Organization Name
- Dwayne Johnson MD Psc
- Primary Specialty
- Pediatrics
- Enumeration Date
- Feb 27, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 2211 MEADOW DR
- City
- Louisville
- State
- Kentucky
- ZIP Code
- 40218-1330
- Phone
- (502) 458-2577
Authorized Official
- Name
- DR. DWAYNE EDWARD JOHNSON, M.D.
- Title
- PRESIDENT
- Phone
- (502) 458-2577
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pediatrics |
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