Individual
DR. JIMMY D JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
17255 DAVENPORT ST, OMAHA, NE 68118-4092
(402) 763-6466
Mailing address
125 S 66TH ST, LINCOLN, NE 68510-2302
(402) 489-9776
(402) 489-9946
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
847
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6967
BLUE CROSS
NE
Enumeration date
02/24/2007
Last updated
05/25/2023
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