Individual
DR. GLEN E JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
675 OLD BALLAS RD STE 100, CREVE COEUR, MO 63141-7083
(314) 733-9009
Mailing address
675 OLD BALLAS RD STE 100, CREVE COEUR, MO 63141-7083
(314) 733-9009
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
R4H56
MO
Other
Enumeration date
07/27/2006
Last updated
10/29/2021
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