Individual
DR. EUGENE F JOHNSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
242 HILLCREST DR, PRINCETON, WV 24740-2063
(304) 425-1185
Mailing address
PO BOX 634715, CINCINNATI, OH 45263-0001
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
964
WV
207Q00000X
Family Medicine Physician
964
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000449500
BCBS
WV
05
—
0051311000
—
WV
05
—
010090521
—
VA
05
—
010369177
—
VA
01
—
080055548
RAILROAD MEDICARE
WV
01
—
P00233412
RAILROAD MEDICARE
WV
Enumeration date
06/07/2006
Last updated
01/04/2023
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