Provider Demographics
NPI:1255531596
Name:JOHNS, RACHELLE LYNN (MD)
Entity type:Individual
Prefix:
First Name:RACHELLE
Middle Name:LYNN
Last Name:JOHNS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 JEFFERSON AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-2538
Mailing Address - Country:US
Mailing Address - Phone:724-527-8060
Mailing Address - Fax:724-522-4002
Practice Address - Street 1:6521 ROUTE 22
Practice Address - Street 2:
Practice Address - City:DELMONT
Practice Address - State:PA
Practice Address - Zip Code:15626-2402
Practice Address - Country:US
Practice Address - Phone:724-836-5500
Practice Address - Fax:724-836-3286
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.142663207RG0100X
PAMD431916207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101950377Medicaid
PA117308Medicare PIN