Archer, Johanna Suzanne

Archer, Johanna Suzanne is an sole proprietor health care provider with primary practice located at 6420 Dutchmans Pkwy Suite 395, Louisville KY 40205-3372. She recently has only one registered license in Allopathic & Osteopathic Physicians / Reproductive Endocrinology, which is considered as her primary health care specialty. Archer, Johanna Suzanne can be contacted via phone (502) 749-6420.

Contact Information

Primary practice address
6420 Dutchmans Pkwy Suite 395 Louisville KY 40205-3372
Phone: (502) 749-6420
Fax: (502) 749-6426
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Reproductive Endocrinology 207VE0102X 41480 Kentucky

Profile Details

NPI number 1295796662
LBN Legal business name Archer, Johanna Suzanne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 28th, 2006
Last updated Oct 14th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295796662 NPPES
Indiana MEDICAID 200883710
Indiana Other 50017026
Indiana Other 7372351
Indiana Other 000000542618
Indiana Other 50017027
Indiana Other H64013
Indiana Other 000000542447
Indiana Other 50017025
Indiana MEDICAID 7100016980

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