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NPI Code Detail

MEDICARE: LYNN M. JOHNSON MD, PLLC

MEDICARE: LYNN M. JOHNSON MD, PLLC
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
1208000000XPediatrics Physician35083078JOH

General Provider Information

NPI Number : 1568613099
Entity Type Code : Organization
Provider Name (Legal Business Name) : LYNN M. JOHNSON MD, PLLC
Provider Business Mailing Address
First Line : 550 TRUMBULL AVE
Second Line :
City : CORTLAND
State : OH
Zip : 44410-9403
Country : US
Telephone Number : 330-637-2000
Fax Number : 330-637-2001
Provider Business Practice Location Address
First Line : 550 TRUMBULL AVE
Second Line :
City : CORTLAND
State : OH
Zip : 44410-9403
Country : US
Telephone Number : 330-637-2000
Fax Number : 330-637-2001
Authorized Official
Title or Position : OWNER
Name : DR. LYNN MARIE JOHNSON
Credential : MD
Telephone Number : 330-637-2000
Provider Enumeration Date : 10/02/2008
Last Update Date : 10/02/2008

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