Organization
LIGHTHOUSE MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN H. JOHNSON MD (CEO/OWNER)
81479431271
Entity
Organization
Contact information
Practice address
418 N LOGAN BLVD, SUITE A, BURNHAM, PA 17009-1816
(717) 242-3900
Mailing address
311 E. PLEASANT VALLY BLVD, ALTOONA, PA 16602
(814) 943-1271
(814) 940-8516
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD044867E
PA
208100000X
Physical Medicine & Rehabilitation Physician
MD438515
PA
2084N0400X
Neurology Physician
MD441685
PA
208VP0014X
Interventional Pain Medicine Physician
OS015480
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020712560001
—
PA
Enumeration date
06/21/2011
Last updated
02/28/2017
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