Johnson, Jerome Gordon

Johnson, Jerome Gordon is an individual health care provider with primary practice located at 1000 Mon Health Medical Park Dr Suite 1100, Morgantown WV 26505-1104. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Johnson, Jerome Gordon can be contacted via phone (304) 599-1448.

Contact Information

Primary practice address
1000 Mon Health Medical Park Dr Suite 1100 Morgantown WV 26505-1104
Phone: (304) 599-1448
Fax: (304) 599-5335
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 08973 West Virginia

Profile Details

NPI number 1033292339
LBN Legal business name Johnson, Jerome Gordon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2006
Last updated Jan 8th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033292339 NPPES
West Virginia MEDICAID 0127517000
West Virginia Other WV5365C185
West Virginia Other 001719639

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