Organization
JACKSON VISION LLC
Active
Other names
Jackson Vision
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN G JOHNSON O.D. (OPTOMETRIST)
(517) 782-4300
Entity
Organization
Contact information
Practice address
817 W GANSON ST, JACKSON, MI 49202-4255
(517) 782-4300
(517) 782-4708
Mailing address
817 W GANSON ST, JACKSON, MI 49202-4255
(517) 782-4300
(517) 782-4708
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003631
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22-20042
PHP #
MI
01
—
900C810850
BCBS
MI
Enumeration date
03/02/2007
Last updated
04/16/2014
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