Individual
DR. THOMAS MARK JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 EXECUTIVE CENTER PKWY, SUITE 102, FREDERICKSBURG, VA 22401-3177
(540) 654-5333
(540) 654-5334
Mailing address
7501 GREENWAY CENTER DR, SUITE 300, GREENBELT, MD 20770-3514
(301) 441-4577
(301) 474-4679
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
0101231064
VA
207W00000X
Ophthalmology Physician
D0057684
MD
207W00000X
Ophthalmology Physician
MD32823
DC
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
D0057684
MD
207WX0107X
Retina Specialist (Ophthalmology) Physician
MD32823
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
027275400
—
DC
05
—
1366498545
—
VA
05
—
691200100
—
MD
Enumeration date
05/26/2006
Last updated
04/09/2019
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