Organization
STEPHEN M JOHNSON MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA CHATLOS (OFFICE COORDINATOR)
(317) 817-1762
Entity
Organization
Contact information
Practice address
200 W 103RD ST, STE 1000, INDIANAPOLIS, IN 46290-1092
(317) 817-1765
(317) 817-1767
Mailing address
200 W 103RD ST, STE 1000, INDIANAPOLIS, IN 46290-1092
(317) 817-1765
(317) 817-1767
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01027083
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100072660A
—
IN
Enumeration date
07/11/2007
Last updated
12/18/2012
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