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Individual

DR. WILLIAM BLAIR JOHNSON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1325 E FORTIFICATION ST, JACKSON, MS 39202
(601) 354-4488
(601) 351-5980
Mailing address
1325 E FORTIFICATION ST, JACKSON, MS 39202-2442
(601) 354-4488
(601) 351-5980

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0101264334
VA
207X00000X
Orthopaedic Surgery Physician
Primary
26435
MS

Other

Enumeration date
07/01/2013
Last updated
06/19/2019
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