Provider Demographics
NPI:1255959433
Name:JOHNSON, AARON (OD)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:JOHNSON
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 1:132 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:KS
Mailing Address - Zip Code:67063-1526
Mailing Address - Country:US
Mailing Address - Phone:620-947-5631
Mailing Address - Fax:620-947-3511
Practice Address - Street 1:607 E RANDALL ST
Practice Address - Street 2:
Practice Address - City:HESSTON
Practice Address - State:KS
Practice Address - Zip Code:67062-8814
Practice Address - Country:US
Practice Address - Phone:620-327-2800
Practice Address - Fax:620-327-2055
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2122152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist