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NPI Code Detail

MEDICARE: HEIDI ANN JOHNSON MD

MEDICARE: HEIDI ANN JOHNSON MD
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
1207R00000XInternal Medicine Physician01048906AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000313568OTHERINBCBS

General Provider Information

NPI Number : 1194876318
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEIDI ANN JOHNSON MD
Provider Business Mailing Address
First Line : 4778 S SCATTERFIELD RD
Second Line :
City : ANDERSON
State : IN
Zip : 46013-2908
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4778 S SCATTERFIELD RD
Second Line :
City : ANDERSON
State : IN
Zip : 46013-2908
Country : US
Telephone Number : 765-646-6331
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2007
Last Update Date : 10/26/2022

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