Gavin Lane Johnson, OD

Optometrist · Brigham City, UT

Individual Active NPI

NPI number 1194340745

Practice location

34 S Main St
Brigham City, UT 84302-2527
Phone
(435) 723-2485
Fax
(435) 723-5840

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NPI record

NPI
1194340745
Entity type
Individual (Type 1)
Enumeration date
June 10, 2020
Last updated
January 11, 2024
Certified
January 11, 2024
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Optometrist Primary 152W00000X 12753476-9934 UT

Mailing address

110 E 750 N
Mantua, UT 84324-4343
Phone
(435) 730-3998

About Dr. Johnson

Gavin Lane Johnson, OD is a healthcare provider registered in the NPI registry with the primary taxonomy Optometrist (code 152W00000X). The practice location is 34 S Main St, Brigham City, UT 84302-2527. The NPI number 1194340745 was assigned on June 10, 2020 and the record was last updated on January 11, 2024.

Dr. Johnson lists a license in the registry: #12753476-9934 (UT) for Optometrist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Gavin Lane Johnson, OD?

The NPI number is 1194340745.

What is the phone number of Dr. Johnson?

The phone number listed for the practice location is (435) 723-2485.

Where is Dr. Johnson located?

34 S Main St, Brigham City, UT 84302-2527.

What is the taxonomy code for Dr. Johnson?

The primary taxonomy code is 152W00000X – Optometrist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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