Individual
DR. MACK WRAY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
301 NORTHRIDGE CIR, GUYMON, OK 73942-2735
(580) 338-8437
(580) 338-8361
Mailing address
301 NORTHRIDGE CIR, GUYMON, OK 73942-2735
(580) 338-8437
(580) 338-8361
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2159
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100764570A
—
OK
Enumeration date
08/04/2006
Last updated
07/08/2007
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