Organization
JOHNSON VISION DEVELOPMENT CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAULA JOHNSON-WYATT OD (OWNER/OPTOMETRIST)
(731) 660-1100
Entity
Organization
Contact information
Practice address
1012 GREYSTONE SQUARE, JACKSON, TN 38305
(731) 660-1100
(731) 660-0688
Mailing address
1012 GREYSTONE SQUARE, JACKSON, TN 38305
(731) 660-1100
(731) 660-0688
Taxonomy
Speciality
Code
Description
License number
State
152WP0200X
Pediatric Optometrist
Primary
—
—
152WV0400X
Vision Therapy Optometrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5440904
—
TN
05
—
Q028220
—
TN
Enumeration date
02/02/2012
Last updated
09/25/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us