Johnson, Donna Sue
Johnson, Donna Sue is an sole proprietor health care provider with primary practice located at 418 S Poplar Suite 5, Centralia IL 62801. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Johnson, Donna Sue can be contacted via phone (618) 533-4929.Contact Information
Primary practice address
418 S Poplar Suite 5
Centralia IL 62801
Phone: (618) 533-4929
Fax: (618) 533-4929
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 046007821 | Illinois |
Profile Details
| NPI number | 1174565378 |
|---|---|
| LBN Legal business name | Johnson, Donna Sue |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 12th, 2006 |
| Last updated | Aug 12th, 2008 - about 16 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 | 1174565378 | NPPES |
| Illinois | MEDICAID | 046007821 |
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