Provider Demographics
NPI:1427017490
Name:JOHNSON, MICHAEL ALANDO (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ALANDO
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 FRANKLIN ST
Mailing Address - Street 2:P.O. BOX 232
Mailing Address - City:SPRINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14141-0232
Mailing Address - Country:US
Mailing Address - Phone:716-592-5006
Mailing Address - Fax:716-592-5007
Practice Address - Street 1:27 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:14141-0232
Practice Address - Country:US
Practice Address - Phone:716-592-5006
Practice Address - Fax:716-592-5007
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192833-1207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY192833-2OtherWORKERS COMPENSATION
NY0807662OtherINDEPENDENT HEALTH ASS.
NY00020009104OtherUNIVERA HEALTH CARE
NYNY 2833OtherEYE MED VISION CARE
NY0807662OtherINDEPENDENT HEALTH ASS.
NY11922 BMedicare ID - Type Unspecified