Johnson, Thomas Dwayne

Johnson, Thomas Dwayne is an sole proprietor health care provider with primary practice located at 1417 N Main St , Jamestown KY 42629-2411. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Johnson, Thomas Dwayne can be contacted via phone (270) 343-2597.

Contact Information

Primary practice address
1417 N Main St Jamestown KY 42629-2411
Phone: (270) 343-2597
Fax: (270) 343-2598
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 37317 Kentucky
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 37317 Kentucky

Profile Details

NPI number 1821096421
LBN Legal business name Johnson, Thomas Dwayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 8th, 2005
Last updated Jan 10th, 2023 - about 2 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 1821096421 NPPES
Kentucky Other 000000294096 ANTHEM BC/BS

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