| John H Johnson, MD | |
| 30 Mallard Court, Beckley, WV 25801-3140 | |
| (304) 255-0800 | |
| (304) 255-1040 | 
| Full Name | John H Johnson | 
|---|---|
| Gender | Male | 
| Speciality | Pediatrics | 
| Location | 30 Mallard Court, Beckley, West Virginia | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1922003318 | NPI | - | NPPES | 
| 3002516001 | Medicaid | WV | |
| 562370581001 | Other | WV | BSMT-WV | 
| 010056306 | Medicaid | VA | |
| 562370581 | Other | WV | UMWA | 
| 7663338 | Other | WV | AETNA | 
| 141518 | Other | WV | CARELINK | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208000000X | Pediatrics | 20381 (West Virginia) | Primary | 
| Entity Name | Beckley Pediatric Associates Ltd | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1487699542 PECOS PAC ID: 6103889332 Enrollment ID: O20041109000731 | 
| Mailing Address | Practice Location Address | 
|---|---|
| John H Johnson, MD Po Box 460, White Sulphur Springs, WV 24986-0460 Ph: (304) 536-5030 | John H Johnson, MD 30 Mallard Court, Beckley, WV 25801-3140 Ph: (304) 255-0800 | 
| Carlos Estanislao Lucero, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 403 Carriage Drive, Beckley, WV 25801 Phone: 304-255-7456 Fax: 304-255-5899 | |
| Dr. Petaiah Mohan, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 194 Carriage Dr, Beckley, WV 25801 Phone: 304-255-6051 Fax: 304-255-6051 | |
| Ramon Lacanilao, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 30 Mallard Court, Beckley, WV 25801 Phone: 304-255-0800 Fax: 304-255-1040 | |
| Kim D Bennett, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 252 Rural Acres Dr, Beckley, WV 25801 Phone: 304-252-8551 Fax: 304-252-1790 | |
| Dr. Michele Dawn Staton, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2401 S Kanawha St, Suite 110a, Beckley, WV 25801 Phone: 304-929-4646 Fax: 304-929-4649 | |
| Dr. Malik Hamdan, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1710 Harper Rd, Beckley, WV 25801 Phone: 304-256-4100 Fax: 304-254-3016 | |
| Dr. Saraswathi Mohan, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 194 Carriage Dr, Beckley, WV 25801 Phone: 304-255-6051 Fax: 304-255-6051 |