Provider Demographics
NPI:1700855566
Name:JOHNSON, K. PAIGE K (MD)
Entity Type:Individual
Prefix:DR
First Name:K. PAIGE
Middle Name:K
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1932 ALCOA HWY
Mailing Address - Street 2:150
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1527
Mailing Address - Country:US
Mailing Address - Phone:865-546-1642
Mailing Address - Fax:865-305-6195
Practice Address - Street 1:1932 ALCOA HWY
Practice Address - Street 2:150
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1527
Practice Address - Country:US
Practice Address - Phone:865-546-1642
Practice Address - Fax:865-305-6195
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37316207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3886492Medicaid
TN3373353Medicare PIN
TN3886492Medicaid
TNH88988Medicare UPIN