Individual
JORDAN LANE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5211 GERMAN CT, COLUMBUS, IN 47203-9689
(812) 657-1026
Mailing address
5211 GERMAN CT, COLUMBUS, IN 47203-9689
(812) 657-1026
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
IN
Other
Enumeration date
01/10/2023
Last updated
01/10/2023
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