Individual
GARY MICHAEL JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1010 CARONDELET DR, STE 220, KANSAS CITY, MO 64114-4859
(816) 941-1600
(816) 941-1699
Mailing address
1010 CARONDELET DR, STE 220, KANSAS CITY, MO 64114-4859
(816) 941-1600
(816) 941-1699
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO R5613
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110213633
RAILROAD MEDICARE
MO
05
—
240233429
—
MO
01
—
2762200003
CIGNA HEALTHCARE OF KANSAS/MISSOURI, INC
MO
01
—
4534129
AETNA US HEALTHCARE
MO
Enumeration date
06/05/2006
Last updated
09/02/2010
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