Organization
DR HEIDI JOHNSON OD PC
Active
Other names
Superior Eye Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI LEE JOHNSON O.D., F.C.O.V.D. (OWNER, OPTOMOTRIST)
(906) 228-4401
Entity
Organization
Contact information
Practice address
2822 VENTURE DR, MARQUETTE, MI 49855-8631
(906) 228-4401
(906) 225-0460
Mailing address
2822 VENTURE DR, MARQUETTE, MI 49855-8631
(906) 228-4401
(906) 225-0460
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
MI
152WP0200X
Pediatric Optometrist
—
—
152WV0400X
Vision Therapy Optometrist
—
GU
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3115352
—
MI
01
—
900E211060
BCBS
MI
01
—
900E265343
BCBS
MI
Enumeration date
07/15/2006
Last updated
03/27/2009
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