Individual
JOHN W JOHNSTON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1314 19TH AVE, MERIDIAN, MS 39301-4116
(601) 703-4926
(601) 703-4928
Mailing address
PO BOX 5392, MERIDIAN, MS 39302-5392
(601) 703-4926
(601) 703-4928
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
14986
MS
207Q00000X
Family Medicine Physician
Primary
14986
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00121566
—
MS
01
—
168390702
US DEPT OF LABOR
MS
01
—
753068151
MS HEALTH PARTNERS
MS
01
—
753068151008
TRICARE
MS
01
—
770143
AETNA
MS
01
—
P00292073
RR MEDICARE
MS
Enumeration date
03/09/2006
Last updated
05/12/2023
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