Johnson, Gary Lynn

Johnson, Gary Lynn is an individual health care provider with primary practice located at 610 Chestnut St , South Charleston WV 25309-1251. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Johnson, Gary Lynn can be contacted via phone (304) 766-7515.

Contact Information

Primary practice address
610 Chestnut St South Charleston WV 25309-1251
Phone: (304) 766-7515
Fax: (304) 766-7566
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 01092 West Virginia

Profile Details

NPI number 1336116003
LBN Legal business name Johnson, Gary Lynn
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 2nd, 2006
Last updated Dec 17th, 2007 - about 18 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 1336116003 NPPES
West Virginia Other 1071247 WV DWC
West Virginia Other 01092 WV DWC

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