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Individual

DR. MARLA Y JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3330 MASONIC DR, ALEXANDRIA, LA 71301-3841
(318) 448-6827
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
714-L
MS
2080N0001X
Neonatal-Perinatal Medicine Physician
21599
MS
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
MD.206128
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07002256
MS
05
177371
AL
Enumeration date
07/07/2008
Last updated
04/20/2022
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