Johnson, Thomas Mark

Johnson, Thomas Mark is an individual health care provider with primary practice located at 200 Executive Center Pkwy Suite 102, Fredericksburg VA 22401-3177. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist. Allopathic & Osteopathic Physicians / Retina Specialist is his primary health care specialty. Johnson, Thomas Mark can be contacted via phone (540) 654-5333.

Contact Information

Primary practice address
200 Executive Center Pkwy Suite 102 Fredericksburg VA 22401-3177
Phone: (540) 654-5333
Fax: (540) 654-5334
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X D0057684 Maryland
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 0101231064 Virginia
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X MD32823 District of Columbia
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X MD32823 District of Columbia
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X D0057684 Maryland

Profile Details

NPI number 1366498545
LBN Legal business name Johnson, Thomas Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2006
Last updated Apr 9th, 2019 - about 6 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 1366498545 NPPES
District of Columbia MEDICAID 027275400
District of Columbia MEDICAID 1366498545
District of Columbia MEDICAID 691200100

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