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NPI Code Detail

MEDICARE: ROBERT W JOHNSON

MEDICARE: ROBERT W JOHNSON
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
1174400000XSpecialist
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1245583020
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT W JOHNSON
Provider Business Mailing Address
First Line : 5050 MADISON RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45227-1491
Country : US
Telephone Number : 513-272-2800
Fax Number : 513-631-7484
Provider Business Practice Location Address
First Line : 615 ELSINORE PL STE 500
Second Line :
City : CINCINNATI
State : OH
Zip : 45202-1455
Country : US
Telephone Number : 513-231-6630
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2012
Last Update Date : 04/24/2024

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