Individual
DR. JOHNNY YORK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
930 HANES MALL BLVD, WINSTON SALEM, NC 27103
(336) 760-1291
(336) 760-1295
Mailing address
PO BOX 15601, WINSTON SALEM, NC 27113
(336) 760-1291
(336) 760-1295
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1096
NC
152WC0802X
Corneal and Contact Management Optometrist
1096
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0998G
BCBS PROVIDER NUMBER
NC
01
—
1096
STATE LICENSE NUMBER
NC
Enumeration date
05/03/2007
Last updated
09/11/2025
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