Provider Demographics
NPI:1043247190
Name:JOHNSON-KEYS, KAY F (MD)
Entity type:Individual
Prefix:
First Name:KAY
Middle Name:F
Last Name:JOHNSON-KEYS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAY
Other - Middle Name:F
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1808 W BELTLINE HWY
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-2334
Mailing Address - Country:US
Mailing Address - Phone:608-250-1497
Mailing Address - Fax:608-250-1384
Practice Address - Street 1:3400 E RACINE ST
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53546-2344
Practice Address - Country:US
Practice Address - Phone:608-373-8000
Practice Address - Fax:608-371-8928
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI63731-20207VX0000X
IN01059804A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200501040Medicaid
OH2920361Medicaid
OH2920361Medicaid
IN200501040Medicaid