Individual
JOHNSON J THOTTAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4800 HIGBEE AVE NW, CANTON, OH 44718-2528
(330) 492-8521
(330) 492-1967
Mailing address
4800 HIGBEE AVE NW, CANTON, OH 44718-2528
(330) 492-8521
(330) 492-1967
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
37564
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0366303
—
OH
Enumeration date
03/15/2006
Last updated
07/30/2010
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