Individual
ROGER T JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
MAIN ST, FAMILY HEALTHCARE ASSOC INC, PINEVILLE, WV 24874
(304) 732-6735
(304) 732-9161
Mailing address
PO BOX 1650, FAMILY HEALTHCARE ASSOC INC, PINEVILLE, WV 24874
(304) 732-6735
(304) 732-9161
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
122
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810000499
—
WV
Enumeration date
09/28/2006
Last updated
07/08/2007
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