Provider Demographics
NPI:1467593533
Name:ERKINS, JOHNNY MACK (MD)
Entity Type:Individual
Prefix:
First Name:JOHNNY
Middle Name:MACK
Last Name:ERKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 E WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-5572
Mailing Address - Country:US
Mailing Address - Phone:620-275-9752
Mailing Address - Fax:620-275-4306
Practice Address - Street 1:310 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5572
Practice Address - Country:US
Practice Address - Phone:620-275-9752
Practice Address - Fax:620-275-4306
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.040836207V00000X
WAMD60407479207V00000X
KS04-44192207V00000X
OH30540836E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2030952Medicaid
OH0375624Medicaid
OHER0460973OtherPPIN