Individual
LATOYA P. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1134 WINTER ST, JACKSON, MS 39204-2841
(601) 948-5572
Mailing address
3502 W NORTHSIDE DR, JACKSON, MS 39213-4454
(601) 948-5572
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/04/2014
Last updated
09/24/2018
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