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Individual

DR. DONALD J JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
3600 WASHBURN WAY, KLAMATH FALLS, OR 97603-4539
(541) 883-1669
Mailing address
PO BOX 759, ASHLAND, OR 97520-0026
(541) 488-1417

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1642 ATI
OR
152WC0802X
Corneal and Contact Management Optometrist
1642 ATI
OR
152WL0500X
Low Vision Rehabilitation Optometrist
1642ATI
OR
152WP0200X
Pediatric Optometrist
1642ATI
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
031380
OR
Enumeration date
12/27/2007
Last updated
02/10/2008
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