Individual
ZACKERY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6051 U S HIGHWAY 49, HATTIESBURG, MS 39401-7200
(601) 288-4242
Mailing address
986 HIGHWAY 48 E, TYLERTOWN, MS 39667-7115
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
JOHN-5CVAJZ
MS
Other
Enumeration date
07/12/2020
Last updated
07/12/2020
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