Organization
LIGHTHOUSE MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN H. JOHNSON MD (CEO/OWNER)
(814) 943-1271
Entity
Organization
Contact information
Practice address
301 E. PLEASANT VALLEY BLVD, ALTOONA, PA 16602
(814) 944-5835
(814) 944-9184
Mailing address
311 E. PLEASANT VALLEY BLVD., ALTOONA, PA 16602
(814) 943-1271
(814) 940-8516
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD044867E
PA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
MD438515
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020712560001
—
PA
Enumeration date
01/17/2013
Last updated
02/28/2017
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