Gary Lynn Johnson, PA

NPI #1336116003 in South Charleston, West Virginia

Provider Information

NPI Number: 1336116003
Entity Type: Individual
Name: Gary Lynn Johnson, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Mar 2, 2006
Last Updated: Dec 17, 2007

Practice Location

Address: 610 CHESTNUT ST
City: South Charleston
State: West Virginia
ZIP Code: 25309-1251
Phone: (304) 766-7515

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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