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Individual

THOMAS J JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
350 N SWITZER CANYON DR, SUITE 130, FLAGSTAFF, AZ 86001-4826
(928) 773-9697
(928) 774-4224
Mailing address
4800 N 22ND ST, PHOENIX, AZ 85016-4701
(602) 955-1000
(602) 508-4830

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
01128
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
599425
AZ
Enumeration date
07/27/2006
Last updated
03/20/2015
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