Provider Demographics
NPI:1396950184
Name:JOHNSON, GENE AIDAN (MD)
Entity type:Individual
Prefix:DR
First Name:GENE
Middle Name:AIDAN
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:150 SEVENTH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-2908
Mailing Address - Country:US
Mailing Address - Phone:440-285-2020
Mailing Address - Fax:440-285-8448
Practice Address - Street 1:150 SEVENTH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-2908
Practice Address - Country:US
Practice Address - Phone:440-285-2020
Practice Address - Fax:440-285-8448
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2022-07-26
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Provider Licenses
StateLicense IDTaxonomies
OH35.093768207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4269651Medicare PIN