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General NPI Number Information
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NPI Number | 1003173436
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Entity Type | Individual
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Provider Name | BRANDON TERON JOHNSON MD
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Gender | Male
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Dates
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Enumeration Date | 04/23/2012
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 4880 NE GOODVIEW CIR
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City | LEES SUMMIT
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State | MO
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Zip | 64064-1996
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Country | US
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Telephone | 816-478-4200
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Fax | 816-875-2598
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Provider Business Mailing Address
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Address Line | 5101 COLLEGE BLVD
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City | LEAWOOD
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State | KS
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Zip | 66211-1614
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Country | US
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Telephone | 816-478-4200
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Fax | 816-875-2597
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 04-40523
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 2017043658
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License Number State | MO
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