Provider Demographics
NPI:1891375721
Name:JOHNSON, THOMAS W (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:W
Last Name:JOHNSON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:251 SALINA MEADOWS PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212
Mailing Address - Country:US
Mailing Address - Phone:315-464-2096
Mailing Address - Fax:315-464-2010
Practice Address - Street 1:6620 FLY ROAD
Practice Address - Street 2:SUITE 305
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057
Practice Address - Country:US
Practice Address - Phone:315-464-3938
Practice Address - Fax:315-464-5359
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2025-12-24
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Provider Licenses
StateLicense IDTaxonomies
NY3362582084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology