Organization
JUANTINA JOHNSON MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUANTINA JOHNSON MD (OWNER/MANAGER)
(877) 953-4864
Entity
Organization
Contact information
Practice address
1314 19TH AVE, MERIDIAN, MS 39301-4116
(877) 953-4864
Mailing address
757 BURTON CLARK RD, DE KALB, MS 39328-6145
(877) 953-4864
(770) 953-8132
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
21445
MS
Other
Enumeration date
10/15/2012
Last updated
11/16/2012
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