Organization
SAMUEL D JOHNSON OD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMEUL JOHNSON OD (OWNER)
(910) 628-8316
Entity
Organization
Contact information
Practice address
204 IONA ST, FAIRMONT, NC 28340-1616
(910) 628-8316
(910) 628-5642
Mailing address
PO BOX 648, FAIRMONT, NC 28340-0648
(910) 628-8316
(910) 628-5642
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2337
NC
Other
Enumeration date
05/09/2018
Last updated
05/09/2018
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