Individual
DR. DWIGHT C JOHNSON
Active
Individual
DR. DWIGHT C JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS007597L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2346974001
KEYSTONE
PA
01
—
85992
AETNA
PA
01
—
868042YHGL
MEMBER PROVIDER IDENTIFICATION NUMBER
PA
Enumeration date
02/08/2006
Last updated
01/09/2014
Update your record
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