Individual
DR. ROBERT D. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1965 S FREMONT AVE, SUITE 370, SPRINGFIELD, MO 65804-2201
(417) 820-0300
(417) 882-9645
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
R6G23
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202413415
—
MO
01
—
81817
AR BLUE SHIELD #
MO
Enumeration date
02/06/2007
Last updated
09/08/2010
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