Individual
DR. OWEN CANNON JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
302 CHURCH ST, A, GEORGETOWN, SC 29440-2406
(843) 546-2244
(843) 546-2255
Mailing address
302 CHURCH ST, GEORGETOWN, SC 29440-2406
(843) 546-2244
(843) 546-2255
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1279
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D12791
—
SC
Enumeration date
05/17/2006
Last updated
05/09/2023
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