Organization
JIM A. JOHNSON, O.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JIM A. JOHNSON O.D. (PRESIDENT)
(785) 827-1010
Entity
Organization
Contact information
Practice address
1820 S OHIO ST, SALINA, KS 67401-6607
(785) 827-1010
Mailing address
1820 S OHIO ST, SALINA, KS 67401-6607
(785) 827-1010
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1354-3
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000651148
BLUE CROSS BLUESHIELD KS
KS
01
—
1354-3
KANSAS LICENSE OPTOMETRY
KS
Enumeration date
03/27/2007
Last updated
11/16/2007
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