Provider Demographics
NPI:1841581790
Name:JOHNSON, JOHN H (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:H
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:188 MEDICAL PARK DRIVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:BREVARD
Mailing Address - State:NC
Mailing Address - Zip Code:28712-4188
Mailing Address - Country:US
Mailing Address - Phone:828-884-7320
Mailing Address - Fax:828-884-7944
Practice Address - Street 1:188 MEDICAL PARK DRIVE
Practice Address - Street 2:SUITE C
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-4188
Practice Address - Country:US
Practice Address - Phone:828-884-7320
Practice Address - Fax:828-884-7944
Is Sole Proprietor?:No
Enumeration Date:2011-04-27
Last Update Date:2016-12-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY279509-1207W00000X
NC2016-00694207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology