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NPI Code Detail

MEDICARE: PATRICIA LYNN JOHNSON MD

MEDICARE:   PATRICIA LYNN JOHNSON  MD
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
1171100000XAcupuncturist01044746AIN
2207V00000XObstetrics & Gynecology Physician01044746AIN
3208VP0000XPain Medicine Physician01044746AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000001367OTHERMPLAN PROVIDER ID NUMBER
2000001073792OTHERINANTHEM PTAN
3000000383685OTHERANTHEM PROVIDER ID NUMBER
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891736864
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA LYNN JOHNSON MD
Provider Business Mailing Address
First Line : 250 N SHADELAND AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-4959
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1275 PARKWAY DR
Second Line :
City : ZIONSVILLE
State : IN
Zip : 46077-1953
Country : US
Telephone Number : 317-873-8900
Fax Number : 317-873-2655
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2006
Last Update Date : 06/04/2025

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Directions to “ PATRICIA LYNN JOHNSON MD” Practice Location

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