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General NPI Number Information
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NPI Number | 1518994060
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Entity Type | Individual
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Provider Name | MARIA SMITH JOHNSON OD
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Gender | Female
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 04/21/2021
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Provider Practice Location Address
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Address Line | 2100 W CORNWALLIS DR STE J
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City | GREENSBORO
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State | NC
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Zip | 27408-7015
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Country | US
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Telephone | 336-288-3937
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Fax | 336-288-8177
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Provider Business Mailing Address
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Address Line | PO BOX 207261
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City | DALLAS
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State | TX
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Zip | 75320-7261
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Country | US
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Telephone | 636-200-4393
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Fax | 636-527-0766
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1938
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License Number State | NC
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