Provider Demographics
NPI:1437855541
Name:JOHNSON, THOMAS DANIEL
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:DANIEL
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7124 DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-8330
Mailing Address - Country:US
Mailing Address - Phone:614-804-2791
Mailing Address - Fax:
Practice Address - Street 1:7124 DAVIS RD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-8330
Practice Address - Country:US
Practice Address - Phone:614-804-2791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)