Individual
DR. JOHNSON UNDERWOOD IV
Active
Individual
DR. JOHNSON UNDERWOOD IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
112408
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100299860A
—
KS
01
—
14730
CMFHP
MO
05
—
1861429979
—
MO
01
—
24439012
BCBSKC
MO
01
—
300074147
RR MEDICARE
MO
01
—
5087570
AETNA
MO
Enumeration date
06/26/2006
Last updated
12/07/2011
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