Johnson, Greg R
Johnson, Greg R is an individual health care provider with primary practice located at 3909 New Vision Dr , Fort Wayne IN 46845-1725. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Johnson, Greg R can be contacted via phone (260) 469-6602.Contact Information
Primary practice address
3909 New Vision Dr
Fort Wayne IN 46845-1725
Phone: (260) 469-6602
Fax: (260) 969-3065
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 02001531A | Indiana |
Profile Details
| NPI number | 1013960269 |
|---|---|
| LBN Legal business name | Johnson, Greg R |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 18th, 2006 |
| Last updated | Dec 21st, 2022 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013960269 | NPPES |
| Indiana | Other | 000000675115 | ANTHEM |
| Indiana | MEDICAID | 200015220 | ANTHEM |
| Indiana | Other | P00895098 | ANTHEM |
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