Individual
DR. JERI BENTON JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5131 ODONOVAN DR, SUITE 201, BATON ROUGE, LA 70808-4791
(225) 374-0220
(225) 374-0221
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 765-5727
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
14002R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110232767
RAILROAD MEDICARE
LA
05
—
1187771
—
LA
Enumeration date
07/27/2005
Last updated
03/26/2021
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