Jack F Johnson Jr, MD | |
1190 Summers Ave, Orangeburg, SC 29115-4922 | |
(803) 534-0266 | |
Not Available |
Full Name | Jack F Johnson Jr |
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Gender | Male |
Speciality | Ophthalmology |
Location | 1190 Summers Ave, Orangeburg, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1902912322 | NPI | - | NPPES |
061113 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207W00000X | Ophthalmology | 6111 (South Carolina) | Primary |
Entity Name | Orangeburg Eye Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1194831586 PECOS PAC ID: 8628108370 Enrollment ID: O20100608000031 |
Mailing Address | Practice Location Address |
---|---|
Jack F Johnson Jr, MD Po Box 1226, Orangeburg, SC 29116-1226 Ph: (803) 534-0266 | Jack F Johnson Jr, MD 1190 Summers Ave, Orangeburg, SC 29115-4922 Ph: (803) 534-0266 |
Daoling Zhang, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 1190 Summers Ave, Orangeburg, SC 29115 Phone: 803-534-0266 | |
Michael James Mcmullen, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 1190 Summers Ave, Orangeburg, SC 29115 Phone: 803-534-0266 | |
Mark C Mcgannon, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 1190 Summers Ave, Orangeburg, SC 29115 Phone: 803-534-0266 |