Individual
DR. ANTONIETTE JOHNSON DRIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1009 E CHURCH ST, SUITE A, LEXINGTON, TN 38351-1947
(731) 968-1926
(731) 968-1996
Mailing address
PO BOX 1045, LEXINGTON, TN 38351-1045
(731) 968-1926
(731) 968-1996
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD 1814
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3154581
BLUE CROSS BLUE SHIELD
TN
05
—
3941512
—
TN
Enumeration date
07/05/2005
Last updated
05/26/2008
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