Individual
WILLIAM ALEXANDER JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1400 HIGHLAND RD STE 1, RICHMOND, IN 47374-8810
(765) 935-8905
(765) 939-4200
Mailing address
1100 REID PKWY, MEDICAL STAFF SERVICES, RICHMOND, IN 47374-1157
(765) 935-8905
(765) 935-4200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
TC813
KY
363A00000X
Physician Assistant
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100593300
—
KY
Enumeration date
09/05/2018
Last updated
05/17/2019
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