Individual
WARFORD B JOHNSON II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3100 STATE HWY W, OZARK, MO 65721-8135
(417) 849-2077
Mailing address
3100 STATE HWY W, OZARK, MO 65721-8135
(417) 849-2077
(417) 359-2679
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
R4304
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201933512
—
MO
01
—
6132
BLUE CROSS/BLUE SHIELD
—
01
—
P01212545
RAIL ROAD MEDICARE
MO
Enumeration date
06/14/2006
Last updated
11/21/2020
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