# LIGHTHOUSE MEDICAL LLC

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

## Provider details

- **NPI number:** 1831478049
- **Authorized official:** JOHN H. JOHNSON MD (CEO/OWNER)
- **Authorized official phone:** (814) 943-1271

## Contact information

- **Practice address:** 253 EASTERLY PKWY, SUITE 1, STATE COLLEGE, PA 16801-6301
- **Practice address phone:** (814) 308-8456
- **Practice address fax:** (814) 308-8728
- **Mailing address:** 311 E. PLEASANT VALLEY 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 | — |
| 208VP0014X | Interventional Pain Medicine Physician | OS015480 | PA | — |

## Other

- **Enumeration date:** 08/05/2011
- **Last updated:** 02/28/2017