Healthcare Provider Details

I. General information

NPI: 1306079165
Provider Name (Legal Business Name): ERIN YVONNE JOHNSON M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN YVONNE WILLHOITE M.D.

II. Dates (important events)

Enumeration Date: 08/27/2009
Last Update Date: 12/29/2022
Certification Date: 12/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 GLENSBORO RD
LAWRENCEBURG KY
40342-9033
US

IV. Provider business mailing address

330 SEVEN SPRINGS WAY
BRENTWOOD TN
37027-5098
US

V. Phone/Fax

Practice location:
  • Phone: 502-839-4091
  • Fax: 502-839-9650
Mailing address:
  • Phone: 615-920-7906
  • Fax: 615-920-8775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number45284
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberIP113
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberR2039
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number45284
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: