| Mr Larry C Johnson, MD | |
|
120 Progress Way, Owenton, KY 40359-6032 | |
| (844) 655-6100 | |
| (502) 484-2102 |
| Full Name | Mr Larry C Johnson |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 27 Years |
| Location | 120 Progress Way, Owenton, Kentucky |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285653618 | NPI | - | NPPES |
| 64051022 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 35775 (Kentucky) | Primary |
| 207P00000X | Emergency Medicine | 35775 (Kentucky) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Personal Touch Home Care Of Ky | Fort thomas, KY | Home health agency |
| St Elizabeth Florence | Florence, KY | Hospital |
| St Elizabeth Grant | Williamstown, KY | Hospital |
| St Elizabeth Edgewood | Edgewood, KY | Hospital |
| Frankfort Regional Medical Center | Frankfort, KY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Triad Health Systems, Inc. | 4082798699 | 17 |
| Entity Name | Southeastern Emergency Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356379382 PECOS PAC ID: 2466364997 Enrollment ID: O20050302000285 |
| Entity Name | Triad Health Systems, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831311299 PECOS PAC ID: 4082798699 Enrollment ID: O20100806000077 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Larry C Johnson, MD 1401 Madison Ave, Covington, KY 41011-3313 Ph: (859) 655-6100 | Mr Larry C Johnson, MD 120 Progress Way, Owenton, KY 40359-6032 Ph: (844) 655-6100 |
Mr. Eric C. Baumann, MD Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 120 Progress Way, Owenton, KY 40359 Phone: 844-655-6100 Fax: 502-484-2102 | |
Mr. Douglas M Smalara, MD Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 120 Progress Way, Owenton, KY 40359 Phone: 844-655-6100 Fax: 502-484-2102 |