Individual
ZACKERY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1320 MAPLEWOOD AVE, RONCEVERTE, WV 24970-8016
(043) 647-4411
Mailing address
400 ASSOCIATION DR STE 102, CHARLESTON, WV 25311-1298
(304) 388-1724
(304) 388-1721
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4395
WV
207P00000X
Emergency Medicine Physician
OT020569
PA
Other
Enumeration date
05/12/2021
Last updated
09/30/2024
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