Johnson, Jack F
Johnson, Jack F is an individual health care provider with primary practice located at 1190 Summers Ave , Orangeburg SC 29115-4922. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Johnson, Jack F can be contacted via phone (803) 534-0266.Contact Information
Primary practice address
1190 Summers Ave
Orangeburg SC 29115-4922
Phone: (803) 534-0266
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 6111 | South Carolina |
Profile Details
| NPI number | 1902912322 |
|---|---|
| LBN Legal business name | Johnson, Jack F |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 21st, 2006 |
| Last updated | Oct 9th, 2007 - about 19 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 | 1902912322 | NPPES |
| South Carolina | MEDICAID | 061113 |
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