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1669476495

NPI Code Detail

MEDICARE: DR. WILLIAM LEE JOHNSON MD

MEDICARE: DR. WILLIAM LEE 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	2080P0201X	Pediatric Allergy/Immunology Physician	R1F19	MO
2	208000000X	Pediatrics Physician	R1F19	MO

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	:	1669476495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM LEE JOHNSON MD

Provider Business Mailing Address
First Line	:	1 CHILDRENS PL
Second Line	:	CB 8116
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-1002
Country	:	US
Telephone Number	:	314-454-2694
Fax Number	:	314-454-2515

Provider Business Practice Location Address
First Line	:	1 CHILDRENS PL
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-1002
Country	:	US
Telephone Number	:	314-454-2694
Fax Number	:	314-454-2515

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	01/24/2018

Similar Medicare Providers

1104828771 — DR. MICHELE E KEMP MD
Practice Location Address:

1 CHILDRENS PL
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63110-1002

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Practice Fax: 314-454-2515

1811999485 — DR. GARY M GOODMAN MD
Practice Location Address:

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1053385880 — DR. PETER H MICHELSON MD
Practice Location Address:

1 CHILDRENS PL STE C , STE C
SAINT LOUIS, MO
63110-1002

Practice Phone: 314-454-2694
Practice Fax: 314-454-2515

1649221953 — DR. JEFFREY RADFORD STOKES MD
Practice Location Address:

1 CHILDRENS PL , DIV PED ALLERGY/IMMUNO/PULMO
SAINT LOUIS, MO
63110-1002

Practice Phone: 314-454-2694
Practice Fax: 314-454-2515

1578510509 — DR. LISA V SUFFIAN MD
Practice Location Address:

1 CHILDRENS PL
SAINT LOUIS, MO
63110-1002

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1821037334 — DR. RAY S DAVIS MD
Practice Location Address:

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63110-1002

Practice Phone: 314-454-2694
Practice Fax: 314-454-2515

Directions to “ DR. WILLIAM LEE JOHNSON MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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