# BRIAN A JOHNSON MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043356439
- **Authorized official:** BRIAN A JOHNSON MD (PRESIDENT)
- **Authorized official phone:** (574) 946-6644

## Contact information

- **Practice address:** 613 TERRACE DR, WINAMAC, IN 46996-1111
- **Practice address phone:** (574) 946-6644
- **Mailing address:** PO BOX 277, WINAMAC, IN 46996-0277
- **Mailing address phone:** (574) 946-6644

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 01037880 | IN | Yes |

## Other

- **Enumeration date:** 01/30/2007
- **Last updated:** 08/22/2020