Organization
PHILIP J JOHNSON MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP J JOHNSON MD (OWNER)
(260) 422-4757
Entity
Organization
Contact information
Practice address
2418 LAKE AVE, FORT WAYNE, IN 46805-5406
(260) 422-4757
(260) 422-8375
Mailing address
2418 LAKE AVE, FORT WAYNE, IN 46805-5406
(260) 422-4757
(260) 422-8375
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/10/2015
Last updated
12/10/2015
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