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General NPI Number Information
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NPI Number | 1386834547
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Entity Type | Organization
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Legal Business Name | JOHNSTON MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 02/14/2017
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Provider Practice Location Address
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Address Line | 16000 JOHNSTON MEMORIAL DR
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City | ABINGDON
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State | VA
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Zip | 24211-7664
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Country | US
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Telephone | 276-258-4050
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Fax | 276-258-4056
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Provider Business Mailing Address
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Address Line | 16000 JOHNSTON MEMORIAL DR
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City | ABINGDON
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State | VA
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Zip | 24211-7664
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Country | US
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Telephone | 276-258-4050
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Fax | 276-258-4056
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Authorized Official
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Title or Position | CFO
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Name | JOHN L JETER
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Credential |
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Telephone | 276-258-2830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 0101239640
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 0101238469
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 0101237946
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0110002132
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 0101221395
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License Number State | VA
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