MEDICARE: CURTIS DELON JOHNSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	2006012807	MO
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	04-31797	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619927225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CURTIS DELON JOHNSON MD

Provider Business Mailing Address
First Line	:	10301 HICKMAN MILLS DR
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64137-1659
Country	:	US
Telephone Number	:	816-795-6880
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 E 104TH ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-4511
Country	:	US
Telephone Number	:	816-941-6700
Fax Number	:	816-941-7909

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	11/07/2008

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