Provider Demographics
NPI:1588009765
Name:JOHNSON, THOMAS VINCENT III (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:VINCENT
Last Name:JOHNSON
Suffix:III
Gender:M
Credentials:MD, PHD
Other - Prefix:
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Mailing Address - Street 1:9910 FRANKLIN SQUARE DR # 2110
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4902
Mailing Address - Country:US
Mailing Address - Phone:410-933-6421
Mailing Address - Fax:
Practice Address - Street 1:WILMER EYE INSTITUTE, JOHNS HOPKINS HOSPITAL
Practice Address - Street 2:600 NORTH WOLFE STREET, WILMER B-29
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0001
Practice Address - Country:US
Practice Address - Phone:410-955-5650
Practice Address - Fax:410-614-8496
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD84976207W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD84976OtherLICENSE