Provider Demographics
NPI:1225125990
Name:JOHNS, RICHARD S (OD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:S
Last Name:JOHNS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 W 750 S
Mailing Address - Street 2:
Mailing Address - City:WOODS CROSS
Mailing Address - State:UT
Mailing Address - Zip Code:84010-7221
Mailing Address - Country:US
Mailing Address - Phone:801-294-0230
Mailing Address - Fax:
Practice Address - Street 1:512 W 750 S
Practice Address - Street 2:
Practice Address - City:WOODS CROSS
Practice Address - State:UT
Practice Address - Zip Code:84010-7221
Practice Address - Country:US
Practice Address - Phone:801-294-0230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT109146-9934&8908152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist