Individual
DR. CAROL G JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1030 E COUNTY LINE RD, STE B2, INDIANAPOLIS, IN 46227-2933
(317) 887-6060
(317) 859-5946
Mailing address
2086 FOX MOOR TER, GREENWOOD, IN 46143-9276
(317) 887-3519
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01037716
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000087991
ANTHEM
IN
05
—
100102110
—
IN
Enumeration date
06/20/2005
Last updated
07/01/2024
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