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Individual

NORMAN C JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
828 S BROAD ST, SCOTTSBORO, AL 35768-2508
(256) 259-4119
(256) 259-3643
Mailing address
15933 CLAYTON RD, SUITE 201, BALLWIN, MO 63011-2172
(636) 200-4393
(636) 527-0766

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S464TA172
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
051513019
AL
Enumeration date
02/03/2006
Last updated
11/15/2016
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