Smith, Johnny Dwayne

Smith, Johnny Dwayne is an individual health care provider with primary practice located at 11 N Locust St , Buckhannon WV 26201-2231. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Smith, Johnny Dwayne can be contacted via phone (304) 472-1600.

Contact Information

Primary practice address
11 N Locust St Buckhannon WV 26201-2231
Fax: (304) 472-6055
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 1672 West Virginia

Profile Details

NPI number 1043239817
LBN Legal business name Smith, Johnny Dwayne
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2006
Last updated Oct 27th, 2014 - about 11 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 1043239817 NPPES
West Virginia Other 001721765 MOUNTAIN STATE BCBS
West Virginia Other WV01672 MOUNTAIN STATE BCBS
West Virginia MEDICAID 3810001252 MOUNTAIN STATE BCBS
West Virginia Other P00154078 MOUNTAIN STATE BCBS
West Virginia Other 001721766 MOUNTAIN STATE BCBS

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