Individual
SCOTT E JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1005 N 6TH ST, BLYTHEVILLE, AR 72315-1707
(870) 763-0760
(870) 838-1051
Mailing address
1005 N 6TH ST, BLYTHEVILLE, AR 72315-1707
(870) 763-0760
(870) 838-1051
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2479
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134450722
—
AR
Enumeration date
02/23/2006
Last updated
12/03/2013
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