Individual
DR. DAVID R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2001 W 86TH ST., ST. VINCENT EMERGENCY PHYSICIANS, INC, INDPLS, IN 46260-1902
(317) 802-3140
(317) 870-0499
Mailing address
4685 RELIABLE PKWY, ST VINCENT EMERGENCY PHYSICIANS, INC, CHICAGO, IL 60686-0046
(317) 802-3140
(317) 870-0499
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01037139
IN
207Q00000X
Family Medicine Physician
Primary
01037139
IN
207Q00000X
Family Medicine Physician
01037139A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200013730
—
IN
05
—
200013750
—
IN
Enumeration date
11/22/2005
Last updated
01/22/2009
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