Organization
ADVANCED LAPAROSCOPIC ASSOCIATES OF MS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALFRED BERNARD JOHNSON MD (LAPAROSCOPIC AND GENERAL SURGEON)
(601) 799-3011
Entity
Organization
Contact information
Practice address
1018 SIXTH AVE, PICAYUNE, MS 39466-3837
(601) 799-3011
(601) 799-5417
Mailing address
1018 SIXTH AVE, PICAYUNE, MS 39466-3837
(601) 799-3011
(601) 799-5417
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
19035
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05935394
—
MS
Enumeration date
06/25/2006
Last updated
11/14/2007
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