Individual
OLIVIA R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1701 N SENATE BLVD # AG012, INDIANAPOLIS, IN 46202-1239
(317) 278-3807
Mailing address
1701 N SENATE BLVD # AG012, INDIANAPOLIS, IN 46202-1239
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01090847A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2021
Last updated
07/20/2023
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