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Organization

BLUEGRASS NEUROLOGICAL SERVICES, PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
THOMAS W JOHNSON JR. M.D. (OWNER)
(317) 567-2180
Entity
Organization

Contact information

Practice address
321 S 3RD ST, SUITE A, DANVILLE, KY 40422-2001
(859) 936-0094
(859) 936-0095
Mailing address
9899 E 126TH ST, FISHERS, IN 46038-2821
(317) 567-2179
(317) 567-2191

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
38102
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200378110
IN
05
64069156
KY
Enumeration date
09/15/2006
Last updated
08/27/2009
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