Johnson, Terry G

Johnson, Terry G is an sole proprietor health care provider with primary practice located at 210 Us Highway 27 N , Avon Park FL 33825-3073. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Johnson, Terry G can be contacted via phone (863) 453-3850.

Contact Information

Primary practice address
210 Us Highway 27 N Avon Park FL 33825-3073
Phone: (863) 453-3850
Fax: (863) 452-1462
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPC3011 Florida

Profile Details

NPI number 1750465845
LBN Legal business name Johnson, Terry G
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 25th, 2006
Last updated Aug 26th, 2008 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750465845 NPPES
Florida MEDICAID 620195400

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