Individual
DR. JOHANNA SUZANNE ARCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6420 DUTCHMANS PKWY, SUITE 395, LOUISVILLE, KY 40205-3372
(502) 749-6420
(502) 749-6426
Mailing address
6420 DUTCHMANS PKWY, SUITE 395, LOUISVILLE, KY 40205-3372
(502) 749-6420
(502) 749-6426
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
41480
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000542447
ANTHEM
—
01
—
000000542618
ANTHEM
—
05
—
200883710
—
IN
01
—
50017025
PASSPORT SPECIALTY
KY
01
—
50017026
PASSPORT SPECIALITY
KY
01
—
50017027
PASSPORT PCP
KY
05
—
7100016980
—
KY
01
—
7372351
AETNA
—
01
—
H64013
UPIN
KY
Enumeration date
03/28/2006
Last updated
10/14/2011
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