NPI 1205970365

Larry Dean Johnson, PA

Practitioner Physician Assistant Branson, MO

Practice location

Address: 525 Branson Landing Blvd, Branson, MO 65616-2052
Phone: (417) 348-8646
Fax: (417) 335-7529
Mailing address: PO Box 802843, Kansas City, MO 64180-2843

Registered specialties (2)

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 2018044339 (MO)

Other Physician Assistant providers in Missouri →

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA-263 (AR)

Registry record

NPI: 1205970365
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Feb 2007
Record last updated: 26 May 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.