Most Relevant Information
Provider Data
| NPI Number: | 1003801283 |
| Provider Name: | RUSSELL F JOHNSON MD |
| Entity Type: | Individual |
| Taxonomy Code: | 2085R0001X |
| Specialty: | Radiology |
| License Number: | 01039533 |
Most Important Dates
| Enumeration Date: | 09/14/2005 |
| Last Updated: | 07/16/2021 |
Provider Practice Location
1215 LAWN AVE STE 120
ELKHART
IN
465142450
Practice Location Phone/Fax
| Phone: | 5745232733 |
| Fax: | 5745233251 |
Provider Mailing Location
710 N NILES AVE
SOUTH BEND
IN
466171924
Provider Mailing Phone/Fax
| Phone: | 5746471610 |
| Fax: |