Individual
ALEX R JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1318 KANSAS DR, PAOLA, KS 66071-2107
(913) 557-5678
(913) 557-5681
Mailing address
1318 KANSAS DR, PAOLA, KS 66071-2107
(913) 557-5678
(913) 557-5681
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-45104
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30004763240001
—
KS
Enumeration date
04/18/2017
Last updated
10/06/2022
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