Provider Demographics
NPI:1619927225
Name:JOHNSON, CURTIS DELON (MD)
Entity type:Individual
Prefix:
First Name:CURTIS
Middle Name:DELON
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10301 HICKMAN MILLS DR
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64137-1659
Mailing Address - Country:US
Mailing Address - Phone:816-795-6880
Mailing Address - Fax:
Practice Address - Street 1:1300 E 104TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-4511
Practice Address - Country:US
Practice Address - Phone:816-941-6700
Practice Address - Fax:816-941-7909
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006012807207LP2900X
KS04-31797207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200386010Medicaid
MO201194008Medicaid
MOI56025Medicare UPIN
KS200386010Medicaid