Provider Demographics
NPI:1922095264
Name:JOHNSTON, JAMES P (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:P
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 BRANDYWINE BLVD
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1083
Mailing Address - Country:US
Mailing Address - Phone:740-973-7458
Mailing Address - Fax:
Practice Address - Street 1:1400 BRANDYWINE BLVD
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1083
Practice Address - Country:US
Practice Address - Phone:740-973-7458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-007193J OH207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHJ00889683OtherMEDICARE
OHH02912OtherUPIN
OH9338071OtherMEDICARE PTIN
OH2139733Medicaid
OHJ00889683OtherMEDICARE