Individual
DR. ERIC J JOHNSON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1301 20TH AVE, MERIDIAN, MS 39301-4121
(601) 485-2368
(601) 693-2174
Mailing address
PO BOX 1551, MERIDIAN, MS 39302-1551
(601) 485-2368
(601) 693-2174
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
684
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00880212
—
MS
05
—
051554358
—
AL
01
—
1942285564
GROUP NPI
—
01
—
410048407
RAILROAD MEDICARE
MS
01
—
640931945
TAX ID
—
01
—
CH5554
RAILROAD MEDICARE GROUP
MS
01
—
CH6608
RAILROAD GROUP ID
AL
01
—
P00281824
RAILROAD MEDICARE
AL
Enumeration date
07/27/2006
Last updated
05/19/2008
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