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General NPI Number Information
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NPI Number | 1851682470
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Entity Type | Individual
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Provider Name | JORDAN S JOHNSON MD
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Gender | Male
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Dates
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Enumeration Date | 04/30/2011
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 9821 S MAY AVE STE C
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City | OKLAHOMA CITY
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State | OK
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Zip | 73159-7042
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Country | US
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Telephone | 405-691-0505
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Fax | 405-691-0507
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Provider Business Mailing Address
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Address Line | 3037 NW 63RD ST STE W251
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-3637
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Country | US
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Telephone | 405-691-0505
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Fax | 405-691-0507
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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 | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | 32660
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License Number State | OK
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