Individual
RONALD J JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
204 SOUTH STREET, ANNA, IL 62906-0548
(618) 833-8551
(618) 833-2911
Mailing address
204 SOUTH STREET, ANNA, IL 62906-0548
(618) 833-8551
(618) 833-2911
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036-090683
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036090683
—
IL
Enumeration date
07/12/2005
Last updated
07/14/2015
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