Individual
GLENDA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2400 HOSPITAL DR, SUITE 240, BOSSIER CITY, LA 71111-2385
(318) 742-5800
(318) 741-3902
Mailing address
2400 HOSPITAL DR, SUITE 240, BOSSIER CITY, LA 71111-2385
(318) 742-5800
(318) 741-3902
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
14496R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1125539
—
LA
Enumeration date
05/27/2005
Last updated
12/21/2007
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