Individual
SANDRA MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 HOSPITAL DR, COLUMBIA, MO 65212-0001
(573) 882-1506
(573) 884-5575
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
2020032290
MO
207W00000X
Ophthalmology Physician
ME133380
FL
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
2020032290
MO
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
ME133380
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021901500
—
FL
01
—
RU935
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/07/2006
Last updated
06/06/2024
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