Organization
RUSSO CLINIC-A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM H JOHNSON JR. MD (DOCTOR/OWNER)
(985) 384-1562
Entity
Organization
Contact information
Practice address
1124 7TH ST, MORGAN CITY, LA 70380-1951
(985) 384-1562
(985) 385-6749
Mailing address
PO BOX 2347, MORGAN CITY, LA 70381-2347
(985) 384-1562
(985) 385-6749
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
016985
LA
207R00000X
Internal Medicine Physician
12846B
LA
208600000X
Surgery Physician
Primary
02397R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1167053
—
LA
Enumeration date
08/16/2005
Last updated
09/11/2025
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