Individual
DR. EDWARD WALLACE JOHNSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2703 BEENE BLVD, BOSSIER CITY, LA 71111-5491
(318) 681-4515
(318) 681-4514
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
23591
MS
207Q00000X
Family Medicine Physician
Primary
338347
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
364829701
—
TX
01
—
75-2616977-029
TRICARE
TX
01
—
8GF799
BCBS
TX
01
—
P01754632
RAIL ROAD MEDICARE
TX
Enumeration date
06/17/2013
Last updated
10/23/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us