| Mark D Johnson, OD | |
|
310 W Losey St, Scott Afb, IL 62225 | |
| (618) 256-6267 | |
| (618) 256-7931 |
| Full Name | Mark D Johnson |
|---|---|
| Gender | Male |
| Speciality | Optometrist |
| Location | 310 W Losey St, Scott Afb, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881665073 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 18002934A (Indiana) | Secondary |
| 152W00000X | Optometrist | 046010751 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mark D Johnson, OD 310 W Losey St, Scott Afb, IL 62225-5250 Ph: (618) 256-7361 | Mark D Johnson, OD 310 W Losey St, Scott Afb, IL 62225 Ph: (618) 256-6267 |
National Vision, Inc. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 207 W Winters St, Scott Afb, IL 62225 Phone: 618-744-0277 | |
Dr. Nikki L Beadle, O.D Optometrist Medicare: Not Enrolled in Medicare Practice Location: 310 W Losey St, Scott Afb, IL 62225 Phone: 618-256-9355 |