Organization
JOHNSON MEMORIAL HOSPITAL
Active
Organization
JOHNSON MEMORIAL HOSPITAL
Active
Other names
Johnson Memorial Hospital Health Affiliates
Organization subpart
No
Provider details
NPI number
Authorized official
LARREL I DAILEY (DIRECTOR,REVENUE CYCLE)
(317) 736-3588
Entity
Organization
Contact information
Practice address
1155 W JEFFERSON ST, STE 202, FRANKLIN, IN 46131-2732
(317) 738-7878
(317) 738-7872
Mailing address
PO BOX 800, FRANKLIN, IN 46131-0800
(317) 738-7878
(317) 738-7872
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
005001
IN
207RP1001X
Pulmonary Disease Physician
005001
IN
208M00000X
Hospitalist Physician
005001
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000264062
ANTHEM PROVIDER NUMBER
IN
05
—
200390880A
—
IN
Enumeration date
07/21/2005
Last updated
12/14/2016
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