OrganizationActive
Gary E. Johnson, O.D., P.C.
NPI 1235430216 · Exclusive Provider Organization · Fargo, ND
Provider details
- NPI number
- 1235430216
- Entity type
- Organization
- Primary specialty
- Exclusive Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Gary Johnson, President(701) 640-8773
- License
- 607 (ND)
Specialties & taxonomies
Managed Care Organizations
Practice location
3757 55th Ave S
Fargo, ND 58104-6365
Phone: (701) 356-1717
Fax: (701) 356-1718
Approximate (ZIP-level) locationGet directions
Mailing address
3757 55th Ave S
Fargo, ND 58104-6365
Registry dates
- Enumerated
- 2010-11-08
- Last updated
- 2011-01-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.