Individual
DR. WADE LANE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
104 MOODYS RUN, WILLIAMSBURG, VA 23185-6557
(757) 229-8816
Mailing address
104 MOODYS RUN, WILLIAMSBURG, VA 23185-6557
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101018624
VA
Other
Enumeration date
07/26/2012
Last updated
07/26/2012
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