Individual
DR. WILLIAM LEE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 CHILDRENS PL, SAINT LOUIS, MO 63110-1002
(314) 454-2694
(314) 454-2515
Mailing address
1 CHILDRENS PL, CB 8116, SAINT LOUIS, MO 63110-1002
(314) 454-2694
(314) 454-2515
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
R1F19
MO
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
R1F19
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202878708
—
MO
05
—
ENROLLED
—
IL
Enumeration date
06/09/2005
Last updated
01/24/2018
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