Provider Demographics
NPI:1609932573
Name:JOHNSON, KARIN A (MD)
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:A
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KARIN
Other - Middle Name:A
Other - Last Name:HYDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7950 MARTIN LOOP
Mailing Address - Street 2:
Mailing Address - City:FORT BENNING
Mailing Address - State:GA
Mailing Address - Zip Code:31905-5648
Mailing Address - Country:US
Mailing Address - Phone:706-544-4471
Mailing Address - Fax:706-544-2022
Practice Address - Street 1:7950 MARTIN LOOP
Practice Address - Street 2:
Practice Address - City:FORT BENNING
Practice Address - State:GA
Practice Address - Zip Code:31905-5648
Practice Address - Country:US
Practice Address - Phone:706-544-4471
Practice Address - Fax:706-544-2022
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20661207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery