Basic Information
Provider Information
NPI: 1861923708
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JOHNSON
FirstName: ARIC
MiddleName: JAMES
NamePrefix: DR.
NameSuffix:  
Credential: M.B.B.S.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 ROSE STREET ANESTHESIOLOGY
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405360293
CountryCode: US
TelephoneNumber: 8592180069
FaxNumber:  
Practice Location
Address1: 800 ROSE ST
Address2:  
City: LEXINGTON
State: KY
PostalCode: 40536
CountryCode: US
TelephoneNumber: 8593235956
FaxNumber: 8593231080
Other Information
ProviderEnumerationDate: 03/22/2017
LastUpdateDate: 06/14/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/14/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XR4453KYN Allopathic & Osteopathic PhysiciansAnesthesiology 
207L00000XTP956KYY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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