Individual
DR. SIDNEY A JOHNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2969 CURRAN DR N, JACKSON, MS 39216-4121
(601) 200-3070
Mailing address
PO BOX 4997, JACKSON, MS 39296-4997
(601) 362-0600
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
10704
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000015534
—
MS
05
—
0015534
—
MS
01
—
1497757603
NPI
MS
05
—
1961809
—
LA
Enumeration date
06/01/2005
Last updated
02/13/2023
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