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Individual

MICHAEL ANTHONY JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW

Contact information

Practice address
28 MALLARD CT, BECKLEY, WV 25801-3664
(304) 252-8409
(304) 252-0022
Mailing address
252 RURAL ACRES DR, BECKLEY, WV 25801-3503
(304) 252-8409
(304) 252-0022

Taxonomy

Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
Primary
DP00939097
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0116688000
WV
Enumeration date
12/20/2005
Last updated
01/09/2025
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