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Individual

TONICA VINETTA JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1821 HILLANDALE RD 1B #300, DURHAM, NC 27706
(216) 509-1814
Mailing address
1821 HILLANDALE RD 1B #300, DURHAM, NC 27706
(216) 509-1814

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
200600411
NC
207W00000X
Ophthalmology Physician
A87493
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0800905
UHC
NC
01
1326265
AETNA
NC
01
142VK
BCBS NC
NC
01
188041
MEDCOST
NC
01
33400
OPTICARE
NC
05
5904044
NC
01
808293
PARTNERS
NC
01
OPH182
PRIMAHEALTH
NC
01
P00340942
MEDICARE RAILROAD
Enumeration date
06/03/2006
Last updated
07/21/2022
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