Healthcare Provider Details

I. General information

NPI: 1578752226
Provider Name (Legal Business Name): PEIRCE W. JOHNSTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2007
Last Update Date: 12/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN ST MAIL LOCATION 0796
CINCINNATI OH
45219-2364
US

IV. Provider business mailing address

3200 BURNET AVE 3 SOUTH
CINCINNATI OH
45229-3019
US

V. Phone/Fax

Practice location:
  • Phone: 513-584-1000
  • Fax:
Mailing address:
  • Phone: 513-585-5501
  • Fax: 513-558-0877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number57013520
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: