Provider Demographics
NPI:1356787550
Name:JOHNSON, ANNIE K (MD)
Entity type:Individual
Prefix:DR
First Name:ANNIE
Middle Name:K
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:K
Other - Last Name:BAHLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9582 PRINCETON GLENDALE RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-9709
Mailing Address - Country:US
Mailing Address - Phone:513-346-5640
Mailing Address - Fax:513-346-5644
Practice Address - Street 1:9582 PRINCETON GLENDALE RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-9709
Practice Address - Country:US
Practice Address - Phone:513-346-5640
Practice Address - Fax:513-346-5644
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD81856207Q00000X
OH35.149009207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine