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Individual

ROBERT G JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3603 BIENVILLE BLVD STE 103, OCEAN SPRINGS, MS 39564-5736
(228) 762-3000
(228) 818-4151
Mailing address
2101 HIGHWAY 90, GAUTIER, MS 39553-5340
(228) 497-7576
(228) 497-8869

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
1999138149
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07084205
MS
Enumeration date
09/12/2006
Last updated
08/17/2022
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