| Doctor Name: | DR. KENDRICK DEWAYNE JOHNSON |
| NPI Number: | 1790122141 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 125.063144 |
| Business Practice Address: | Osf St Francis Medical Ctr 530 N.e. Glen Oak Ave Peoria, IL - 616370001 |
| Business Phone Number: | 3096552642 |
| Business Fax Number: | |
| Mailing Address: | 9045 Kingston Rd, Apt 2906 SHREVEPORT |
| State: | LA |
| Postal Code: | 711183466 |
| Phone Number: | 3184269287 |
| Fax Number: | |
| NPI Enumeration Date: | 05/24/2013 |
| NPI Last Update Date: | 05/24/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207T00000X |
| License Number: | 125.063144 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neurological Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |