Provider Demographics
NPI:1871684969
Name:SALMON, JOHN D (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:SALMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4046
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65808-4046
Mailing Address - Country:US
Mailing Address - Phone:417-335-2299
Mailing Address - Fax:417-269-2080
Practice Address - Street 1:890 STATE HIGHWAY 248
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-3721
Practice Address - Country:US
Practice Address - Phone:417-335-2299
Practice Address - Fax:417-269-2080
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2004000959207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
186411OtherBLUE CROSS OF MO
MO208750703Medicaid
916465134Medicare PIN
G48775Medicare UPIN
MO208750703Medicaid
186411OtherBLUE CROSS OF MO
P00127789Medicare PIN