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Individual

HOLLYE R JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
6501 DOGWOOD VIEW PARKWAY, SUITE A, JACKSON, MS 39213
(601) 899-3340
(601) 899-3343
Mailing address
6501 DOGWOOD VIEW PARKWAY, SUITE A, JACKSON, MS 39213
(601) 899-3340
(601) 899-3343

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
15974
MS
207RN0300X
Nephrology Physician
Primary
15974
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04056301
MS
Enumeration date
07/03/2006
Last updated
04/27/2018
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