Individual
MR. WILLIAM DWIGHT JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CFPMHNP
Contact information
Practice address
613 MARQUETTE DRIVE, BRANDON, MS 39042
(601) 824-0342
(601) 824-0349
Mailing address
PO BOX 88, BRANDON, MS 39043
(601) 824-0342
(601) 824-0349
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R857199
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01880504
—
MS
Enumeration date
08/17/2006
Last updated
07/08/2007
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