MEDICARE: FRANK JOHNSON JR. 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
1	207X00000X	Orthopaedic Surgery Physician	01033366A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000086360	OTHER	IN	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1619949708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANK JOHNSON JR. M.D.

Provider Business Mailing Address
First Line	:	13400 N MERIDIAN ST
Second Line	:	SUITE 600
City	:	CARMEL
State	:	IN
Zip	:	46032-7102
Country	:	US
Telephone Number	:	317-582-7529
Fax Number	:	317-582-7602

Provider Business Practice Location Address
First Line	:	13400 N MERIDIAN ST
Second Line	:	SUITE 600
City	:	CARMEL
State	:	IN
Zip	:	46032-7102
Country	:	US
Telephone Number	:	317-582-7529
Fax Number	:	317-582-7602

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	05/27/2009

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