Johnson, Gordon Stanley
Johnson, Gordon Stanley is an individual health care provider with primary practice located at 2827 Woodruff Rd , Simpsonville SC 29681-4807. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Johnson, Gordon Stanley can be contacted via phone (864) 520-2480.Contact Information
Primary practice address
2827 Woodruff Rd
Simpsonville SC 29681-4807
Phone: (864) 520-2480
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 815 | South Carolina |
Profile Details
| NPI number | 1295841369 |
|---|---|
| LBN Legal business name | Johnson, Gordon Stanley |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 22nd, 2006 |
| Last updated | Aug 26th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295841369 | NPPES |
| South Carolina | MEDICAID | DOO815 |
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