Provider Demographics
NPI:1205201019
Name:JOHNSTON EYE CENTER, PLLC
Entity Type:Organization
Organization Name:JOHNSTON EYE CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-531-4651
Mailing Address - Street 1:411 WALNUT ST
Mailing Address - Street 2:SUITE 8869
Mailing Address - City:GREEN COVE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32043-3443
Mailing Address - Country:US
Mailing Address - Phone:904-531-4651
Mailing Address - Fax:
Practice Address - Street 1:142 LINDEN DR
Practice Address - Street 2:SUITE 108
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6901
Practice Address - Country:US
Practice Address - Phone:352-318-3004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-04
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty