Johnson, Brian Alan

Johnson, Brian Alan is an individual health care provider with primary practice located at 613 Terrace Dr , Winamac IN 46996-1111. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Johnson, Brian Alan can be contacted via phone (574) 946-6644.

Contact Information

Primary practice address
613 Terrace Dr Winamac IN 46996-1111
Fax: (574) 946-7801
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01037880 Indiana

Profile Details

NPI number 1023012754
LBN Legal business name Johnson, Brian Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2005
Last updated Jul 8th, 2007 - about 19 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 1023012754 NPPES
Indiana MEDICAID 100210710A

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