Healthcare Provider Details

I. General information

NPI: 1295314367
Provider Name (Legal Business Name): ZACHARY NATHANIEL JOHNS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 LINCOLN WAY STE 310
WHITE OAK PA
15131-2400
US

IV. Provider business mailing address

4 ALLEGHENY CTR FL 7
PITTSBURGH PA
15212-5227
US

V. Phone/Fax

Practice location:
  • Phone: 412-672-7154
  • Fax: 412-672-7159
Mailing address:
  • Phone: 412-330-4461
  • Fax: 412-330-5844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberOS024640
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: