Johnson, Matthew Todd
Johnson, Matthew Todd is an sole proprietor health care provider with primary practice located at 210 State Highway 165 , Branson MO 65616-3464. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Johnson, Matthew Todd can be contacted via phone (417) 339-3996.Contact Information
Primary practice address
210 State Highway 165
Branson MO 65616-3464
Phone: (417) 339-3996
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | 2007021852 | Missouri |
Profile Details
| NPI number | 1891078614 |
|---|---|
| LBN Legal business name | Johnson, Matthew Todd |
| Credentials | PHARM.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 28th, 2011 |
| Last updated | Sep 28th, 2011 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891078614 | NPPES |
| Missouri | Other | T175199001 | DRIVER LICENSE NUMBER |
| Missouri | Other | 2007021852 | DRIVER LICENSE NUMBER |
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