Provider Demographics
NPI:1568469492
Name:JOHNSON, WILLIAM Z II (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:Z
Last Name:JOHNSON
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-5658
Mailing Address - Country:US
Mailing Address - Phone:304-422-1191
Mailing Address - Fax:304-428-5488
Practice Address - Street 1:706 DIVISION ST
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-5658
Practice Address - Country:US
Practice Address - Phone:304-422-1191
Practice Address - Fax:304-428-5488
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV595111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0132297000Medicaid
WVU40741Medicare UPIN
WV0132297000Medicaid