MEDICARE: DR. DANIEL P. JOHNSTON O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPC 3715	FL
2	152W00000X	Optometrist	OEG001893	PA

General Provider Information

NPI Number	:	1831161744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL P. JOHNSTON O.D.

Provider Business Mailing Address
First Line	:	122 WOODMINT DR
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-2102
Country	:	US
Telephone Number	:	813-597-8147
Fax Number	:	610-692-6007

Provider Business Practice Location Address
First Line	:	923 PAOLI PIKE
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-4527
Country	:	US
Telephone Number	:	610-692-8300
Fax Number	:	610-692-6007

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	01/07/2014

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