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Individual

MATTHEW TYLER JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARM.D

Contact information

Practice address
1366 N GARDNER ST, SCOTTSBURG, IN 47170-7793
(812) 752-4226
(812) 752-4056
Mailing address
1366 N GARDNER ST, P.O. BOX 346, SCOTTSBURG, IN 47170-7793
(812) 752-4226
(812) 752-4056

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
016971
KY
183500000X
Pharmacist
Primary
26025460A
IN

Other

Enumeration date
10/09/2015
Last updated
01/20/2017
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