# LIGHTHOUSE MEDICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528354271
- **Authorized official:** JOHN H. JOHNSON MD (CEO/OWNER)
- **Authorized official phone:** 81479431271

## Contact information

- **Practice address:** 418 N LOGAN BLVD, SUITE A, BURNHAM, PA 17009-1816
- **Practice address phone:** (717) 242-3900
- **Mailing address:** 311 E. PLEASANT VALLY BLVD, ALTOONA, PA 16602
- **Mailing address phone:** (814) 943-1271
- **Mailing address fax:** (814) 940-8516

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | MD044867E | PA | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | MD438515 | PA | — |
| 2084N0400X | Neurology Physician | MD441685 | PA | — |
| 208VP0014X | Interventional Pain Medicine Physician | OS015480 | PA | — |

## Other

- **Enumeration date:** 06/21/2011
- **Last updated:** 02/28/2017