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1568453132
MARK SAMUEL JOHNSON
SAINT CHARLES, MO
NPI
1568453132
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MO 2010013488)
Enumeration Date
2005-11-02
Last Update Date
2020-03-13
Business Address
Mr. MARK SAMUEL JOHNSON PA-C MT ASCP
300 1ST CAPITOL DR
SAINT CHARLES, MO 63301-2844
Phone number: 636-947-5000
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Mailing Address
Mr. MARK SAMUEL JOHNSON PA-C MT ASCP
200 CORPORATE BLVD
LAFAYETTE, LA 70508-3870
Phone number: 800-893-9698
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