Johnson, Timothy J.
Johnson, Timothy J. is an individual health care provider with primary practice located at 1623 Central Ave , Los Alamos NM 87544-3018. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Johnson, Timothy J. can be contacted via phone (505) 662-5444.Contact Information
Primary practice address
1623 Central Ave
Los Alamos NM 87544-3018
Phone: (505) 662-5444
Fax: (505) 662-6109
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 458 | New Mexico |
Profile Details
| NPI number | 1205826179 |
|---|---|
| LBN Legal business name | Johnson, Timothy J. |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 24th, 2005 |
| Last updated | Apr 20th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205826179 | NPPES |
| New Mexico | MEDICAID | F5946 | |
| New Mexico | Other | NM00P444 |
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