Individual
DR. ROGER B JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16 E 13TH ST, LAWRENCE, KS 66044-3502
(785) 423-5086
Mailing address
PO BOX 1674, LAWRENCE, KS 66044-8674
(785) 423-5086
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15048
KS
207Q00000X
Family Medicine Physician
2516
AK
207Q00000X
Family Medicine Physician
MDR4H16
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD25162
—
AK
Enumeration date
11/01/2006
Last updated
07/08/2007
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