| Doctor Name: | MR. JOHN M JOHNSON |
| NPI Number: | 1093704678 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | 1041 |
| Business Practice Address: | 202 Maplewood Ave Ronceverte, WV - 249701334 |
| Business Phone Number: | 3046474411 |
| Business Fax Number: | 3046476064 |
| Mailing Address: | 202 Maplewood Ave, RONCEVERTE |
| State: | WV |
| Postal Code: | 24970 |
| Phone Number: | 3046474411 |
| Fax Number: | |
| NPI Enumeration Date: | 10/17/2005 |
| NPI Last Update Date: | 05/07/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 1041 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |