Individual
PHILIP EDWARD JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
901 SHELBY ST, INDIANAPOLIS, IN 46203-1151
(317) 488-2040
(317) 488-2051
Mailing address
3401 E RAYMOND ST, INDIANAPOLIS, IN 46203-4744
(317) 788-9769
(317) 781-4868
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01023460A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100362240
—
IN
Enumeration date
10/06/2005
Last updated
04/13/2011
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