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Organization

LIGHTHOUSE MEDICAL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN H. JOHNSON MD (CEO/OWNER)
(814) 943-1271
Entity
Organization

Contact information

Practice address
253 EASTERLY PKWY, SUITE 1, STATE COLLEGE, PA 16801-6301
(814) 308-8456
(814) 308-8728
Mailing address
311 E. PLEASANT VALLEY BLVD., ALTOONA, PA 16602
(814) 943-1271
(814) 940-8516

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD044867E
PA
208100000X
Physical Medicine & Rehabilitation Physician
MD438515
PA
208VP0014X
Interventional Pain Medicine Physician
OS015480
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1020712560001
PA
Enumeration date
08/05/2011
Last updated
02/28/2017
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