Individual
MRS. ANGEL MICHELLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
50 PARKWAY LN STE 100, PETAL, MS 39465-3035
(601) 705-2897
(601) 584-6457
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 794-8065
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21350
MS
207Q00000X
Family Medicine Physician
390200000X
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07101318
—
MS
Enumeration date
03/27/2008
Last updated
06/02/2025
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