Provider Demographics
NPI:1891777447
Name:JOHNSON, DAVID BRITTON (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:BRITTON
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 1:8940 STATE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-1646
Mailing Address - Country:US
Mailing Address - Phone:913-596-1313
Mailing Address - Fax:913-596-2422
Practice Address - Street 1:8940 STATE AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-1646
Practice Address - Country:US
Practice Address - Phone:913-596-1313
Practice Address - Fax:913-596-2422
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-18731207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100195890AMedicaid
KSC52310Medicare UPIN