Individual
DR. BRIAN ALAN JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
613 TERRACE DR, WINAMAC, IN 46996-1111
(574) 946-6644
(574) 946-7801
Mailing address
613 TERRACE DR, WINAMAC, IN 46996-1111
(574) 946-6644
(574) 946-7801
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01037880
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100210710A
—
IN
Enumeration date
06/10/2005
Last updated
07/08/2007
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