Individual
JOE E JOHNSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5001 HIGHWAY 190 EAST SERVICE RD, SUITE A3, COVINGTON, LA 70433-4930
(985) 893-9251
(985) 892-7893
Mailing address
PO BOX 1855, MANDEVILLE, LA 70470-1855
(985) 893-9251
(985) 892-7893
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
019902
LA
207RP1001X
Pulmonary Disease Physician
Primary
019902
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1970930
—
LA
01
—
P00230927
RAILROAD MEDICARE
LA
Enumeration date
11/17/2005
Last updated
03/26/2021
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