DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. JOHNATHAN VICKERSON, LDO

Active Sole Proprietor

MR. JOHNATHAN VICKERSON, LDO is a Optician, Dispensing healthcare provider located in MORROW, Georgia. NPI 1164297115 is currently active in the NPPES registry. Verify at CMS.

Optician, Dispensing · MORROW, GA

Registration Details

NPI Number
1164297115
Provider Type
Individual
Gender
Male
NPI Issued
Nov 20, 2023 (2.7105895408369 yrs)
Last Updated
Nov 20, 2023
Licenses
002489
002489 (GA)
Sole Proprietor
Yes

Practice Information

Address
7325 JONESBORO RD
MORROW, GA, 302602950
Browse GA providers · Browse ZIP 30260
Phone
4045835162
Fax
6784220759
Primary Specialty
Optician, Dispensing
156FX1800X
Additional Specialty
Health & Wellness Coach
Additional Specialty
Optician, Dispensing

Other Optician, Dispensing Providers in MORROW, GA

Name Credential NPI
CHRISTIAN KYLE JOHNSON LDO 1780549378
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.