NPI 1144584160 · live from the CMS NPI Registry
John Erickson, O.D.
Optometrist, Pediatrics in Jacksonville, FL. National Provider Identifier 1144584160, active.
NPI record
| NPI | 1144584160 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist, Pediatrics 152WP0200X |
| Practice location | 807 Childrens Way, Jacksonville, FL 32207 |
| Practice phone | 904-697-3600 |
| Mailing address | Po Box 191, Rockland, DE 19732 |
| Enumerated | June 25, 2012 |
| Last updated | August 9, 2013 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist, Pediatrics | 152WP0200X | 2012020517 (MO) |
| Optometrist, Pediatrics primary | 152WP0200X | OPC4789 (FL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.