Individual
PETER JAMES JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
107 W CENTRE ST, MAHANOY CITY, PA 17948-2605
(570) 449-8670
Mailing address
509 OAK ST, JIM THORPE, PA 18229-2110
(570) 249-1021
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
SC005660
PA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
SC005660
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SC005660
MEDICAL LICENSE PA
PA
Enumeration date
06/05/2006
Last updated
03/07/2023
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