Dr. Travis M. Johnson
Optometrist
13481 60th St N Suite 200
Stillwater
, Minnesota 55082-1055
Dr. Travis M. Johnson
Optometrist
13481 60th St N Suite 200
Stillwater
, Minnesota 55082-1055
(651) 439-6405
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About
Features
Specialties
- Optometrist
Languages spoken
- English
Location
First Address
- Dr. Travis M. Johnson
- 247 Plum Tree Ln
- Somerset, WI
- Zip : 54025-7578
- Fax : (651) 439-6405
- Phone : (651) 230-3554
Second Address
- Dr. Travis M. Johnson
- 13481 60th St N Suite 200
- Stillwater, MN
- Zip : 55082-1055
- Fax : (651) 439-6405
- Phone : (651) 439-6400
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2763 | MN |
National Provider Identifier
| NPI | 1003890609 |
|---|---|
| Provider Name | Dr. Travis M. Johnson |
| First Address | Somerset, WI 54025-7578 |
| Second Address | Stillwater, MN 55082-1055 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/12/2005 |
| Last Update Date | 20/10/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| U78226 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.