Individual
PATRICIA LYNN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1275 PARKWAY DR, ZIONSVILLE, IN 46077-1953
(317) 873-8900
(317) 873-2655
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
01044746A
IN
207V00000X
Obstetrics & Gynecology Physician
01044746A
IN
208VP0000X
Pain Medicine Physician
Primary
01044746A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000001367
MPLAN PROVIDER ID NUMBER
—
01
—
000000383685
ANTHEM PROVIDER ID NUMBER
—
01
—
000001073792
ANTHEM PTAN
IN
05
—
200167490
—
IN
Enumeration date
06/09/2006
Last updated
06/04/2025
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