Individual
THOMAS E. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
3075 US ROUTE 60 STE A105, HUNTINGTON, WV 25705-8859
(304) 528-4600
Mailing address
3075 US ROUTE 60, HUNTINGTON, WV 25705-8859
(304) 528-4600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
873
WV
363A00000X
Physician Assistant
PA875
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000524203
BCBS
KY
01
—
001930720
BCBS
—
05
—
0111530
—
OH
01
—
1069986
DWC
—
05
—
95006169
—
KY
01
—
P00330689
RAILROAD
—
01
—
P00372239
RAILROAD MEDICARE
WV
Enumeration date
06/23/2006
Last updated
04/24/2025
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