Johnson, Jeffrey R

Johnson, Jeffrey R is an individual health care provider with primary practice located at 1965 S Fremont Ave Suite 370, Springfield MO 65804-2201. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Johnson, Jeffrey R can be contacted via phone (417) 820-0300.

Contact Information

Primary practice address
1965 S Fremont Ave Suite 370 Springfield MO 65804-2201
Phone: (417) 820-0300
Fax: (417) 882-9645
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X R1A74 Missouri

Profile Details

NPI number 1750427399
LBN Legal business name Johnson, Jeffrey R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2007
Last updated May 13th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750427399 NPPES
Arkansas MEDICAID 110070001
Arkansas MEDICAID 201184728

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