Provider Demographics
NPI:1962441212
Name:JOHNSTON, CHAD JAMISON (DO)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:JAMISON
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:3706 S MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-7006
Mailing Address - Country:US
Mailing Address - Phone:540-951-3376
Mailing Address - Fax:540-951-1276
Practice Address - Street 1:3706 S MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-7006
Practice Address - Country:US
Practice Address - Phone:540-951-3376
Practice Address - Fax:540-951-1276
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2020-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA012202352207ND0101X
VA0102202352207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery