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Individual

DR. TIMOTHY DARREL JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
231 ROCKINGHAM RD, BELLOWS FALLS, VT 05101-3138
(802) 463-4488
(802) 463-2543
Mailing address
231 ROCKINGHAM RD, PO BOX 517, BELLOWS FALLS, VT 05101-3138
(802) 463-4488
(802) 463-2543

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
030-0000215
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0006628
VT
01
002590
VSP
VT
01
0174730001
DMERC
VT
01
05012
BANKER'S LIFE
VT
01
0784400
ANTHEM
NH
01
199730
CIGNA
VT
01
59403
MVP
VT
05
99006628
NH
01
JOHN 0776628
BCBS
VT
Enumeration date
08/22/2005
Last updated
06/14/2010
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