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NPI Code Detail

MEDICARE: RAYMOND M JOHNSON M.D.

MEDICARE:   RAYMOND M 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
1207RI0200XInfectious Disease Physician01054865IN

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 : 1497711154
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAYMOND M JOHNSON M.D.
Provider Business Mailing Address
First Line : PO BOX 44994
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46244-0994
Country : US
Telephone Number : 317-274-4402
Fax Number : 317-274-5168
Provider Business Practice Location Address
First Line : 635 BARNHILL DR
Second Line : MS 224
City : INDIANAPOLIS
State : IN
Zip : 46202-5126
Country : US
Telephone Number : 317-274-1427
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2006
Last Update Date : 11/04/2011

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Directions to “ RAYMOND M JOHNSON M.D.” Practice Location

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