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Individual

DR. ROGER F JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
901 SAINT MARYS DR STE 200, EVANSVILLE, IN 47714
(812) 485-6030
Mailing address
901 SAINT MARYS DR STE 200, EVANSVILLE, IN 47714-0509

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
01061986A
IN
207RP1001X
Pulmonary Disease Physician
Primary
01061986A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000489925
ANTHEM
IN
05
200821580
IN
05
64056310
KY
01
P00377506
RAILROAD MEDICARE
IN
Enumeration date
06/07/2006
Last updated
07/06/2022
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