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Individual

DR. DWIGHT C JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
419 N. FRANKLIN STREET, SUITE 3, WEST CHESTER, PA 19380-4435
(610) 344-7703
(610) 344-7797
Mailing address
419 N. FRANKLIN STREET, SUITE 3, WEST CHESTER, PA 19380-4435
(610) 344-7703
(610) 344-7797

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
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