Individual
DR. TIMOTHY STEVEN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
12771 RIVERDALE BLVD NW STE 103, COON RAPIDS, MN 55448-1263
(763) 421-1220
Mailing address
15426 VERDIN ST NW, ANDOVER, MN 55304-4786
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
MN2741
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
173057
UCARE
MN
01
—
186G8JO
BCBS
MN
01
—
22-03191
MEDICA
MN
01
—
22-03192
MEDICA
MN
05
—
253223900
—
MN
01
—
A01991022800
PREFERRED ONE
MN
01
—
HP34135
HEALTHPARTNERS
MN
01
—
MN2741
EYEMED
MN
Enumeration date
02/23/2007
Last updated
03/17/2018
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