Individual
STEPHEN M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10300 N ILLINOIS ST STE 1040, INDIANAPOLIS, IN 46290-1167
(317) 817-1765
(317) 817-1767
Mailing address
10300 N ILLINOIS ST STE 1040, INDIANAPOLIS, IN 46290-1167
(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
03/11/2006
Last updated
07/21/2022
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