Individual
DR. JUANTINA MECHELLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
210 HOSPITAL CIR, CHOCTAW, MS 39350-6781
(601) 389-6302
(601) 663-7924
Mailing address
210 HOSPITAL CIR, CHOCTAW, MS 39350-6781
(601) 389-6302
(601) 663-7924
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
21445
MS
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
MD026588
LA
207Q00000X
Family Medicine Physician
Primary
21445
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01504386
—
MS
Enumeration date
05/08/2006
Last updated
04/22/2014
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