MEDICARE: DR. RICHARD E JOHNS JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	12687	WV

General Provider Information

NPI Number	:	1942204615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD E JOHNS JR. M.D.

Provider Business Mailing Address
First Line	:	106 CANTERBURY DR
Second Line	:
City	:	PARKERSBURG
State	:	WV
Zip	:	26104-8048
Country	:	US
Telephone Number	:	304-422-2702
Fax Number	:	304-485-3373

Provider Business Practice Location Address
First Line	:	106 CANTERBURY DR
Second Line	:
City	:	PARKERSBURG
State	:	WV
Zip	:	26104-8048
Country	:	US
Telephone Number	:	304-422-2702
Fax Number	:	304-485-3373

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	09/09/2022

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