NPI Code Detail JSON Logo

1831107986 NPI number — MACK WRAY JOHNSON O.D.

NPI Number: 1831107986
Health Care Provider/Practitioner: MACK WRAY JOHNSON O.D.

Information about “1831107986” NPI (MACK WRAY JOHNSON O.D.) exists in 1831107986 in HTML format HTML  |  1831107986 in plain Text format TXT  |  1831107986 in PDF (Portable Document Format) PDF  |  1831107986 in an XML format XML  formats.

NPI Number : 1831107986 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1831107986",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JOHNSON",
    "FirstName": "MACK",
    "MiddleName": "WRAY",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "O.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "301 NORTHRIDGE CIR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GUYMON",
    "MailingAddressStateName": "OK",
    "MailingAddressPostalCode": "73942-2735",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "580-338-8437",
    "MailingAddressFaxNumber": "580-338-8361",
    "FirstLinePracticeLocationAddress": "301 NORTHRIDGE CIR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GUYMON",
    "PracticeLocationAddressStateName": "OK",
    "PracticeLocationAddressPostalCode": "73942-2735",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "580-338-8437",
    "PracticeLocationAddressFaxNumber": "580-338-8361",
    "EnumerationDate": "08/04/2006",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "152W00000X",
        "TaxonomyName": "Optometrist",
        "LicenseNumber": "2159",
        "LicenseNumberStateCode": "OK",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.