Individual
DR. KURT DARWIN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
187 DOCTORS DR, PEARL, MS 39208-4042
(601) 932-8722
Mailing address
428 PEMBROOKE DR, MADISON, MS 39110-8260
(601) 824-0929
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11099
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011618
—
MS
Enumeration date
10/18/2005
Last updated
08/20/2020
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