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Organization

LIGHTHOUSE MEDICAL LLC

Active
Other names
Lighthouse Medical Pain Management
Organization subpart
No

Provider details

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

Contact information

Practice address
217 GLENN ST, SUITE 401, CUMBERLAND, MD 21502-2460
(301) 722-7246
(301) 777-2624
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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3366359 00
MD
01
Y925
CAREFIST BC/BS
MD
Enumeration date
04/17/2011
Last updated
02/28/2017
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