Organization
GEORGE M. WOLVERTON M.D. INC.
Active
Other names
Evergreen Medical Centre
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN MITCHELL JOHNSON D.O. (MEDICAL DOCTOR)
(812) 282-4309
Entity
Organization
Contact information
Practice address
300 SPRING ST STE 3B, JEFFERSONVILLE, IN 47130-3498
(812) 282-4309
(812) 283-8299
Mailing address
8009 WEYANOKE CT, PROSPECT, KY 40059-9426
(502) 292-0428
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
50000563
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011760466
RAILROAD MEDICARE
IN
Enumeration date
07/19/2006
Last updated
04/28/2014
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