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NPI Code Detail

MEDICARE: DR. LYNN MARIE JOHNSON M.D.

MEDICARE:  DR. LYNN MARIE JOHNSON  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician35083078JOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043203821
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LYNN MARIE JOHNSON M.D.
Provider Business Mailing Address
First Line : 550 TRUMBULL AVE
Second Line :
City : CORTLAND
State : OH
Zip : 44410-9403
Country : US
Telephone Number : 330-637-2000
Fax Number : 330-637-2001
Provider Business Practice Location Address
First Line : 550 TRUMBULL AVE
Second Line :
City : CORTLAND
State : OH
Zip : 44410-9403
Country : US
Telephone Number : 330-637-2000
Fax Number : 330-637-2001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2005
Last Update Date : 05/07/2008

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Directions to “ DR. LYNN MARIE JOHNSON M.D.” Practice Location

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