Johnson, Timothy Steven
Johnson, Timothy Steven is an individual health care provider with primary practice located at 12771 Riverdale Blvd Nw Ste 103 , Coon Rapids MN 55448-1263. 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 Steven can be contacted via phone (763) 421-1220.Contact Information
Primary practice address
12771 Riverdale Blvd Nw Ste 103
Coon Rapids MN 55448-1263
Phone: (763) 421-1220
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | MN2741 | Minnesota |
Profile Details
| NPI number | 1871629170 |
|---|---|
| LBN Legal business name | Johnson, Timothy Steven |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 23rd, 2007 |
| Last updated | Mar 17th, 2018 - about 6 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 | 1871629170 | NPPES |
| Minnesota | Other | MN2741 | EYEMED |
| Minnesota | Other | A01991022800 | EYEMED |
| Minnesota | Other | HP34135 | EYEMED |
| Minnesota | Other | 186G8JO | EYEMED |
| Minnesota | MEDICAID | 253223900 | EYEMED |
| Minnesota | Other | 22-03191 | EYEMED |
| Minnesota | Other | 22-03192 | EYEMED |
| Minnesota | Other | 173057 | EYEMED |
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