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General NPI Number Information
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NPI Number | 1902625932
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Entity Type | Organization
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Legal Business Name | JOHNSON FAMILY VISION INC.
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 3100 MERIDIAN PARKET DR SUITE J
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City | GREENWOOD
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State | IN
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Zip | 46142-9424
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Country | US
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Telephone | 317-888-9755
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Fax | 317-888-9768
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Provider Business Mailing Address
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Address Line | 3100 MERIDIAN PARKET DR SUITE J
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City | GREENWOOD
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State | IN
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Zip | 46142-9424
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Country | US
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Telephone | 317-888-9755
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Fax | 317-888-9768
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL THOMAS JOHNSON
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Credential | O.D.
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Telephone | 812-345-4912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156F00000X
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Taxonomy Name | Technician/Technologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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