Organization
JOHNSTON MEMORIAL HOSPITAL
Active
Parent organization
JOHNSTON MEMORIAL HOSPITAL, INC
Other names
HOSPITALIST OF JOHNSTON MEMORIAL HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
JOHNSTON MEMORIAL HOSPITAL, INC
Authorized official
JOHN L JETER (CFO)
(276) 258-2830
Entity
Organization
Contact information
Practice address
16000 JOHNSTON MEMORIAL DR, ABINGDON, VA 24211-7664
(276) 258-4050
(276) 258-4056
Mailing address
16000 JOHNSTON MEMORIAL DR, ABINGDON, VA 24211-7664
(276) 258-4050
(276) 258-4056
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
0101221395
VA
208M00000X
Hospitalist Physician
0101237946
VA
208M00000X
Hospitalist Physician
0101238469
VA
208M00000X
Hospitalist Physician
0101239640
VA
363AM0700X
Medical Physician Assistant
0110002132
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
032157100
BLACK LUNG
VA
05
—
1104812684
—
VA
05
—
1525980
—
TN
01
—
618072300
DOL/ENERGY & FECA
VA
01
—
CB9307
RR MEDICARE
VA
Enumeration date
07/25/2007
Last updated
02/14/2017
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