Healthcare Provider Details

I. General information

NPI: 1174691257
Provider Name (Legal Business Name): WILLIAM E JOHNS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 203 MCLISTEN AVE
MINGO JCT OH
43938
US

IV. Provider business mailing address

201 203 MCLISTEN AVE
MINGO JCT OH
43938
US

V. Phone/Fax

Practice location:
  • Phone: 740-535-0555
  • Fax: 740-535-2020
Mailing address:
  • Phone: 740-535-0555
  • Fax: 740-535-2020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number41816
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: