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NPI Code Detail

MEDICARE: DR. SARAH FOARD JOHNSON D.M.D,,CDT

MEDICARE: DR. SARAH FOARD JOHNSON D.M.D,,CDT
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
11223P0700XProsthodonticsKY6887KY

General Provider Information

NPI Number : 1760513675
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SARAH FOARD JOHNSON D.M.D,,CDT
Provider Business Mailing Address
First Line : 2934 BRECKENRIDGE LN STE 1
Second Line :
City : LOUISVILLE
State : KY
Zip : 40220-3903
Country : US
Telephone Number : 502-459-2000
Fax Number : 502-459-4854
Provider Business Practice Location Address
First Line : 2934 BRECKENRIDGE LN STE 1
Second Line :
City : LOUISVILLE
State : KY
Zip : 40220-3903
Country : US
Telephone Number : 502-459-2000
Fax Number : 502-459-4854
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2007
Last Update Date : 07/08/2007

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