Individual
JEREMY M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5601
(601) 984-6601
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5601
(601) 984-6601
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/07/2016
Last updated
04/07/2016
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