Individual
DR. THOMAS JOHN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
10 LINCOLN HWY STE 101, FAIRVIEW HEIGHTS, IL 62208
(618) 624-0222
(618) 624-4930
Mailing address
PO BOX 207163, DALLAS, TX 75320-7154
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008531
IL
Other
Enumeration date
03/09/2007
Last updated
05/14/2018
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