Amanda M Johns, | |
3700 S Main St, Blacksburg, VA 24060-7081 | |
(540) 953-5445 | |
Not Available |
Full Name | Amanda M Johns |
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Gender | Female |
Speciality | Dermatology |
Location | 3700 S Main St, Blacksburg, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1679035091 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207N00000X | Dermatology | TP500 (Kentucky) | Primary |
Entity Name | Modern Dermatology Of Kentucky Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1699382507 PECOS PAC ID: 5496166308 Enrollment ID: O20201125001868 |
Mailing Address | Practice Location Address |
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Amanda M Johns, 3700 S Main St, Blacksburg, VA 24060-7081 Ph: () - | Amanda M Johns, 3700 S Main St, Blacksburg, VA 24060-7081 Ph: (540) 953-5445 |
Luke Godwin, DO Dermatology Medicare: Medicare Enrolled Practice Location: 3706 S Main St Ste B, Blacksburg, VA 24060 Phone: 409-513-3765 | |
Daniel Steven Hurd, DO Dermatology Medicare: Accepting Medicare Assignments Practice Location: 2617 Sheffield Dr, New River Dermatology, Blacksburg, VA 24060 Phone: 540-953-2210 Fax: 540-951-9112 | |
Dr. Chad Jamison Johnston, D.O. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 3706 S Main St, Suite B, Blacksburg, VA 24060 Phone: 540-951-3376 Fax: 540-951-1276 |