Johnson, Amelia M

Johnson, Amelia M is an individual health care provider with primary practice located at 25 N Main St Suite A, Sparta TN 38583-2055. She recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as her primary health care specialty. Johnson, Amelia M can be contacted via phone (931) 836-2235.

Contact Information

Primary practice address
25 N Main St Suite A Sparta TN 38583-2055
Fax: (931) 836-3036
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optician 156FX1800X DPO1192 Tennessee

Profile Details

NPI number 1023099512
LBN Legal business name Johnson, Amelia M
Credentials DPO
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2005
Last updated Jul 9th, 2007 - about 17 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 1023099512 NPPES
Tennessee Other 4073352 BLUE CROSS BLUE SHIELD

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