| Richard Keith Johnson, MD | |
|
1023 Medical Center Pkwy Ste 311, Selma, AL 36701-7740 | |
| (334) 418-6652 | |
| Not Available |
| Full Name | Richard Keith Johnson |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 25 Years |
| Location | 1023 Medical Center Pkwy Ste 311, Selma, Alabama |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669494175 | NPI | - | NPPES |
| 203735600 | Medicaid | MO | |
| 209433 | Other | MO | BLUE SHIELD |
| 752753 | Other | MO | HEALTHLINK |
| 03826375 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 2006015220 (Missouri) | Secondary |
| 208600000X | Surgery | 19773 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Vaughan Regional Medical Center Parkway Campus | Selma, AL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Vaughan Physician Practices, Llc | 8123126851 | 16 |
| Entity Name | Vaughan Physician Practices, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467599621 PECOS PAC ID: 8123126851 Enrollment ID: O20070604000705 |
| Mailing Address | Practice Location Address |
|---|---|
| Richard Keith Johnson, MD 1023 Medical Center Pkwy Ste 311, Selma, AL 36701-7740 Ph: (334) 418-6652 | Richard Keith Johnson, MD 1023 Medical Center Pkwy Ste 311, Selma, AL 36701-7740 Ph: (334) 418-6652 |
Dr. Joseph William Gunter Iii, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 1023 Medical Center Pkwy, Suite 311, Selma, AL 36701 Phone: 334-418-6656 Fax: 334-418-6657 | |
Dr. Charles Leonard Lett Sr., M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 1013 Medical Center Pkwy, Building 1 Suite A, Selma, AL 36701 Phone: 334-875-4374 Fax: 334-875-4340 | |
Glenn Ray Delp, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 200 Vaughan Memorial Dr, Selma, AL 36701 Phone: 334-875-4220 Fax: 334-875-5866 |