Individual
RUSSELL F JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1215 LAWN AVE STE 120, ELKHART, IN 46514-2450
(574) 523-2733
(574) 523-3251
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-3725
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
01039533
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200001710
—
IN
Enumeration date
09/14/2005
Last updated
07/14/2026
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