Provider Demographics
NPI:1982094140
Name:JOHNSON EYE CARE, PA
Entity Type:Organization
Organization Name:JOHNSON EYE CARE, PA
Other - Org Name:KUYKENDALL OPTOMETRIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:BYRON
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:501-605-2687
Mailing Address - Street 1:8511 GEYER SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72209-4949
Mailing Address - Country:US
Mailing Address - Phone:501-568-4218
Mailing Address - Fax:501-568-5131
Practice Address - Street 1:8511 GEYER SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72209-4949
Practice Address - Country:US
Practice Address - Phone:501-568-4218
Practice Address - Fax:501-568-5131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-27
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR2650152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty