1467486142 NPI number — WILLIAM EDWARD JOHNSTON MD

Table of content: BETHANY BRANDT (NPI 1134743388)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467486142 NPI number — WILLIAM EDWARD JOHNSTON MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JOHNSTON
Provider First Name:
WILLIAM
Provider Middle Name:
EDWARD
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467486142
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1020 NO KINGS HWY SUITE 101
Provider Second Line Business Mailing Address:
WILLIAM E JOHNSTON MD PC
Provider Business Mailing Address City Name:
CHERRY HILL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08034
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-482-6464
Provider Business Mailing Address Fax Number:
856-482-5314

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1020 NO KINGS HWY SUITE 101
Provider Second Line Business Practice Location Address:
WILLIAM E JOHNSTON MD PC
Provider Business Practice Location Address City Name:
CHERRY HILL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-482-6464
Provider Business Practice Location Address Fax Number:
856-482-5314
Provider Enumeration Date:
07/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  25MA04072000 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5911524 . This is a "MANAGE CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2108928001 . This is a "AMERIHEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 45001 . This is a "PERSONAL CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 17660 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8951074002 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: K3348 . This is a "HORIZON" identifier . This identifiers is of the category "OTHER".
  • Identifier: P646982 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2K1967 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 94885 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




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