Individual
DR. ALFRED JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6010 BOND AVE, EAST SAINT LOUIS, IL 62207-2328
(618) 337-8153
(618) 337-8905
Mailing address
6010 BOND AVE, EAST SAINT LOUIS, IL 62207-2328
(618) 337-8153
(618) 337-8905
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036086206
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036086206
—
IL
Enumeration date
10/05/2006
Last updated
05/17/2021
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