Johnson, T K
Johnson, T K is an sole proprietor health care provider with primary practice located at 5908 Eastman Ave , Midland MI 48640-6748. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Johnson, T K can be contacted via phone (989) 636-7200.Contact Information
Primary practice address
5908 Eastman Ave
Midland MI 48640-6748
Phone: (989) 636-7200
Fax: (989) 636-7210
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 4901002282 | Michigan |
Profile Details
| NPI number | 1073612107 |
|---|---|
| LBN Legal business name | Johnson, T K |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 22nd, 2006 |
| Last updated | Mar 19th, 2012 - about 14 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 | 1073612107 | NPPES |
| Michigan | Other | 9OOE665040 | BLUE CROSS BLUE SHIELD |
| Michigan | MEDICAID | 1547439 | BLUE CROSS BLUE SHIELD |
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