David Allen Johnson, ATC
Individual provider Active NPI Athletic Trainer · Hanover, IN
NPI 1407584873 · NPPES record last updated Aug 12, 2022
Key facts
- NPI
- 1407584873
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 359 Lagrange
Hanover, IN 47243 - Phone
- (812) 701-2653
- NPI assigned
- Aug 12, 2022
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Yes |
Addresses
Primary practice location
359 Lagrange
Hanover, IN 47243
Mailing address
359 Lagrange
Hanover, IN 47243
Other providers in Hanover, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.