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NPI Code Detail

MEDICARE: DR. STEPHANIE M JOHNSON M.D.

MEDICARE: DR. STEPHANIE 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
1207Q00000XFamily Medicine Physician01054624AIN
2207P00000XEmergency Medicine Physician01054624AIN

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 : 1659368629
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHANIE M JOHNSON M.D.
Provider Business Mailing Address
First Line : 2794 BUTTERCUP CT E
Second Line :
City : COLUMBUS
State : IN
Zip : 47201-3041
Country : US
Telephone Number : 812-418-4230
Fax Number : 812-418-4230
Provider Business Practice Location Address
First Line : 301 HENRY ST
Second Line :
City : NORTH VERNON
State : IN
Zip : 47265-1030
Country : US
Telephone Number : 812-352-4454
Fax Number : 812-418-4230
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2005
Last Update Date : 04/21/2015

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