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:
Health care specialties
Specialty | Code | License # | 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 5 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1366498545 | NPPES |
District of Columbia | MEDICAID | 027275400 | |
District of Columbia | MEDICAID | 1366498545 | |
District of Columbia | MEDICAID | 691200100 |
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