Individual
DR. ROBERT C. JOHNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1965 S FREMONT AVE, SUITE 230, SPRINGFIELD, MO 65804-2201
(417) 820-7250
(417) 820-7255
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2005021461
MO
2086S0127X
Trauma Surgery Physician
Primary
2005021461
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207197807
—
MO
Enumeration date
11/30/2006
Last updated
02/19/2013
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