| Philip J Johnson Md Inc | |
|
2418 Lake Ave Fort Wayne IN 46805-5406 | |
| (260) 422-4757 | |
| (260) 422-8375 |
| Full Name | Philip J Johnson Md Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 2418 Lake Ave, Fort Wayne, Indiana |
| Authorized Official Name and Position | Philip J Johnson (OWNER) |
| Authorized Official Contact | 2604224757 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Philip J Johnson Md Inc 2418 Lake Ave Fort Wayne IN 46805-5406 Ph: (260) 422-4757 | Philip J Johnson Md Inc 2418 Lake Ave Fort Wayne IN 46805-5406 Ph: (260) 422-4757 |
| NPI Number | 1932574324 |
|---|---|
| Provider Enumeration Date | 12/10/2015 |
| Last Update Date | 12/10/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932574324 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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