Provider Demographics
NPI:1770589863
Name:JOHNS, JAMES DEAN (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DEAN
Last Name:JOHNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 15TH ST NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44703-1704
Mailing Address - Country:US
Mailing Address - Phone:330-455-0800
Mailing Address - Fax:330-455-1453
Practice Address - Street 1:211 15TH ST NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44703-1704
Practice Address - Country:US
Practice Address - Phone:330-455-0800
Practice Address - Fax:330-455-1453
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35049624J207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0004260594OtherAETNA
OH0535095Medicaid
OH137831OtherANTHEM ID
OH341753569ZOtherAULTCARE & PRIMETIME
OH87742OtherQUALCHOICE
OH0183865JOtherUNITED HEALTHCARE
OH341753569OtherOHIO HEALTH CHOICE
OH1006OtherSUMMACARE
OHOC03317OtherNATIONWIDE
OH341753569ZOtherAULTCARE & PRIMETIME
OH0535095Medicaid
OH341753569OtherOHIO HEALTH CHOICE