Individual
DR. LIJO JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 N 4TH ST, LONGVIEW, TX 75601-4717
(903) 757-2122
(903) 757-9475
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-2987
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
P7933
TX
207RX0202X
Medical Oncology Physician
Primary
P7933
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
336215401
—
TX
05
—
336215402
—
TX
Enumeration date
04/05/2010
Last updated
05/18/2016
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