Individual
RICHARD E JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
90 BEAVER DR, STE 122-D, DU BOIS, PA 15801-2440
(814) 375-4466
Mailing address
90 BEAVER DR, STE 122-D, DU BOIS, PA 15801-2440
(814) 375-4466
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
OS006605L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174971
—
PA
Enumeration date
12/08/2005
Last updated
04/18/2014
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