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General NPI Number Information
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NPI Number | 1932463445
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Entity Type | Individual
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Provider Name | AMY W JOHNSON DO
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Gender | Female
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Dates
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Enumeration Date | 06/28/2012
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 1001 W 10TH ST OPW M200
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-2859
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Country | US
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Telephone | 317-656-4260
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Fax |
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Provider Business Mailing Address
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Address Line | 250 N SHADELAND AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-4959
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 02004606A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 11016694A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 02004606A
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License Number State | IN
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