| Carl Johnson Medical Center | |
|
307 5th Ave Huntington WV 25702-1815 | |
| (304) 529-4734 | |
| Not Available |
| Full Name | Carl Johnson Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 307 5th Ave, Huntington, West Virginia |
| Authorized Official Name and Position | Richard Weinberger (CFO) |
| Authorized Official Contact | 3045253334 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carl Johnson Medical Center Po Box 1680 Huntington WV 25717-1680 Ph: () - | Carl Johnson Medical Center 307 5th Ave Huntington WV 25702-1815 Ph: (304) 529-4734 |
| NPI Number | 1932189602 |
|---|---|
| Provider Enumeration Date | 01/19/2006 |
| Last Update Date | 05/18/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932189602 | NPI | - | NPPES |
| 6591667800 | Medicaid | KY | |
| 65916702 | Medicaid | KY | |
| 297341901 | Other | WV | BLACK LUNG |
| 0035068000 | Medicaid | WV | |
| 0998756 | Medicaid | OH | |
| CJ2698 | Other | WV | RR MEDICARE GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 20454 (West Virginia) | Primary |
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