Kerry Wayne Johnson, MD

Individual provider Active NPI Obstetrics & Gynecology Physician · Normangee, TX

NPI 1750490405 · NPPES record last updated Aug 14, 2015

Key facts

NPI
1750490405
Entity type
Individual (NPI type 1)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
License
G8878 (TX)
Practice address
910 Hwy 3 West
Normangee, TX 77871
Phone
(936) 396-2806
Fax
(936) 396-9000
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Regional Health Center Past Accepting new patients
Jonathan a. Friedman, M.D., PLLC Past Accepting new patients
Truong-Chinh Q Nguyen MD PLLC Obstetrics & Gynecology Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G8878 TX Yes

Addresses

Primary practice location

910 Hwy 3 West
Normangee, TX 77871

Mailing address

910 Hwy 3 West
Normangee, TX 77871
Phone (936) 396-2806

Other identifiers

IdentifierTypeStateIssuer
0975666-01MedicaidTX

Other providers in Normangee, TX

All providers in Normangee, TX · Obstetrics & Gynecology Physician in Texas

Sources for this page

Verify at the official NPI Registry.