Individual
DAVID A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
611 W. PARK ST., OPTHALMOLOGY/OPTOMETRY, URBANA, IL 61801
(217) 383-3150
(217) 383-4845
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6792
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009048
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0533210001
DMERC
IL
01
—
P00180818
RAILROAD
IL
Enumeration date
07/13/2006
Last updated
05/26/2015
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