Individual
DR. GABRIEL JAY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001770
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA1770
EYEMED
PA
Enumeration date
03/01/2007
Last updated
07/08/2007
Update your record
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