Individual
SCOTT ALLEN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
5600 C L DEES DR, VANCLEAVE, MS 39565-8346
(228) 826-2724
(228) 826-1669
Mailing address
PO BOX 5801, VANCLEAVE, MS 39565-5801
(228) 826-2724
(228) 826-1669
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0876
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0115369
—
MS
01
—
3203A
BC/BS OF LA
LA
01
—
5219536
AETNA NETWORK
MS
01
—
730-69128
BC/BS OF AL
AL
01
—
869651
FIRST HEALTH NETWORK
MS
01
—
CP43105
COMPLETE HEALTH
MS
Enumeration date
03/31/2006
Last updated
08/07/2008
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