Individual
DR. TIMOTHY D. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
Mailing address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3665
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2001017150
MO
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
05-31670
KS
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
2001017150
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208395616
—
MO
Enumeration date
01/03/2006
Last updated
06/13/2011
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