Individual
ALICE HOANG JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3 AUDUBON PLAZA DR, LL-2, LOUISVILLE, KY 40217-1300
(502) 636-8095
(502) 636-8097
Mailing address
PO BOX 7763531, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
45905
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000829388
ANTHEM - NCMA
KY
01
—
149326
SIHO
KY
01
—
50053203
PASSPORT
KY
05
—
7100167540
—
KY
Enumeration date
04/06/2010
Last updated
01/19/2021
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