Johnson Eye Center PLLC
Organization Active NPI Clinic/Center · Philadelphia, MS
NPI 1720794845 · NPPES record last updated May 8, 2023
Key facts
- NPI
- 1720794845
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- JOHNSON EYE CENTER PLLC
- Practice address
- 1120 E Main St Ste 22
Philadelphia, MS 39350-2375 - Phone
- (601) 656-2432
- Fax
- (601) 650-0069
- NPI assigned
- Jan 24, 2023
- Organization subpart
- No
Authorized official
- Name
- Dr. William Lee Johnson, OD
- Title
- Owner
- Phone
- (601) 656-2432
Practitioners 1
-
William Lee Johnson, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240103001131 | MS | Part B Supplier - Clinic/Group Practice | 6002266046 |
Receives reassigned benefits from 1 practitioner Practice locations: Philadelphia, MS |
National Provider Directory
Locations
1120 E Main St
Ste 22
Philadelphia, MS 39350
Phone (601) 656-2432
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
1120 E Main St Ste 22
Philadelphia, MS 39350-2375
Mailing address
1120 E Main St Ste 22
Philadelphia, MS 39350-2375
Phone (601) 656-2432
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25509536 | Other | MS | VSP |
Other names
- Johnson Eye Center
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | johnsoneyecenter@gmail.com | Direct |
Other providers in Philadelphia, MS
- Kayla Jacoby
- Kaelyn James
- Aislin Boler Jayroe
- Adriana Lyn Jenkins
- Jasmine Jennings
- Hannah Johnson
- Shaquetta Monique Johnson
- William Lee Johnson
- Alisha Denise Jones
- Joe Jordan
All providers in Philadelphia, MS · Clinic/Center in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.