Doctor Name: | JOHN RICHARD JOHNSON |
NPI Number: | 1124335823 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 04-10888 |
Business Practice Address: | 1480 N Walnut Mcpherson, KS - 67460 |
Business Phone Number: | 6202412835 |
Business Fax Number: | |
Mailing Address: | 1480 N Walnut, MCPHERSON |
State: | KS |
Postal Code: | 67460 |
Phone Number: | 6202412835 |
Fax Number: | |
NPI Enumeration Date: | 09/02/2010 |
NPI Last Update Date: | 09/10/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 04-10888 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |