Individual
DR. STEPHANIE M JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
301 HENRY ST, NORTH VERNON, IN 47265-1030
(812) 352-4454
(812) 418-4230
Mailing address
2794 BUTTERCUP CT E, COLUMBUS, IN 47201-3041
(812) 418-4230
(812) 418-4230
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01054624A
IN
207Q00000X
Family Medicine Physician
Primary
01054624A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200349990A
—
IN
Enumeration date
10/04/2005
Last updated
04/21/2015
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