Individual
JOHN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
7815 PRESTON HWY, LOUISVILLE, KY 40219-3140
(502) 966-2020
(502) 966-2099
Mailing address
11103 WEST AVE, SUITE 6, SAN ANTONIO, TX 78213-1370
(210) 524-6663
(210) 524-6587
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0765DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77001261
—
KY
Enumeration date
12/22/2006
Last updated
07/09/2007
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