Provider Demographics
NPI:1528322815
Name:JOHNSON, JEPTHA THOMAS III (MD)
Entity type:Individual
Prefix:DR
First Name:JEPTHA
Middle Name:THOMAS
Last Name:JOHNSON
Suffix:III
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 1:3600 FORBES AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3410
Mailing Address - Country:US
Mailing Address - Phone:336-972-1280
Mailing Address - Fax:
Practice Address - Street 1:3600 FORBES AVE STE 140
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3410
Practice Address - Country:US
Practice Address - Phone:336-972-1280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101254918207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology