Individual
MARCUS L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
427 HIGHWAY 51 N, BROOKHAVEN, MS 39601-2350
(601) 833-6011
Mailing address
427 HIGHWAY 51 N, BROOKHAVEN, MS 39601-2350
(601) 833-6011
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
891211
MS
367500000X
Certified Registered Nurse Anesthetist
Primary
901412
MS
Other
Enumeration date
12/23/2016
Last updated
12/23/2016
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