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Thomas William Johnston

Internal Medicine

Allopathic & Osteopathic Physicians

200 E Chestnut St, Louisville, KY 40202-1831

PECOS Enrollment

This provider is enrolled in PECOS as THOMAS JOHNSTON.

Based on the most recent information from CMS, provider Thomas William Johnston is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1750550166
Provider Type
Individual
Full Name
Johnston, Thomas William
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
2/29/2008
Last Updated
9/2/2021

Contact Information

Practice Location

200 E Chestnut St, Louisville, KY 40202-1831

(502) 629-5552

(502) 629-3132

Mailing Location

PO Box 776351, Chicago, IL 60677-6351

(502) 588-9490

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 42922 Kentucky
Code 208D00000X	Description General Practice Allopathic & Osteopathic Physicians	License 42922 Kentucky
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Thomas William Johnston

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Mcmullin, Malik

Winrich, Evan

Parikh, Ishan

University Of Louisville Physicians, Inc.

Shah, Sidra Rehan

Frazier, James Michael

Grigorov, Mladen Vladimirov

Madahar, Shaun

University Of Louisville Research Foundation

Augenstein, Abigail Claire