Individual
MRS. TATUM MAYFIELD JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6766 U S HIGHWAY 98, HATTIESBURG, MS 39402-8443
(601) 549-4877
(601) 901-6061
Mailing address
314 ORAL CHURCH RD, SUMRALL, MS 39482-4021
(601) 606-0558
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
904349
MS
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
09/06/2020
Last updated
10/04/2024
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