Individual
PHILIP GABRIEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1765 E LINCOLN RD, KOKOMO, IN 46902-3993
(765) 236-8380
(907) 543-6366
Mailing address
1765 E LINCOLN RD, KOKOMO, IN 46902-3993
(657) 236-8380
(765) 236-8381
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01084472A
IN
207Q00000X
Family Medicine Physician
102782
AK
207Q00000X
Family Medicine Physician
A123676
CA
Other
Enumeration date
04/27/2011
Last updated
09/01/2023
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