Healthcare Provider Details

I. General information

NPI: 1619927225
Provider Name (Legal Business Name): CURTIS DELON JOHNSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 11/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 E 104TH ST
KANSAS CITY MO
64131-4511
US

IV. Provider business mailing address

10301 HICKMAN MILLS DR
KANSAS CITY MO
64137-1659
US

V. Phone/Fax

Practice location:
  • Phone: 816-941-6700
  • Fax: 816-941-7909
Mailing address:
  • Phone: 816-795-6880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number2006012807
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number04-31797
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: