Organization
GEORGE K. JOHNSON, O.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE KENNETH JOHNSON O,D, (OWNER)
(602) 978-4025
Entity
Organization
Contact information
Practice address
4025 W BELL RD, SUITE 10, PHOENIX, AZ 85053-2750
(602) 978-4025
(602) 843-7101
Mailing address
4025 W BELL RD, SUITE 10, PHOENIX, AZ 85053-2750
(602) 978-4025
(602) 843-7101
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
117
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0901370
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
03/28/2008
Last updated
08/27/2008
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