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Individual

DR. TALAWANGA JOHNSON-BURL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5551 CORPORATE BLVD, SUITE 102, BATON ROUGE, LA 70808-2567
(225) 924-1930
(225) 924-2620
Mailing address
5551 CORPORATE BLVD, SUITE 102, BATON ROUGE, LA 70808-2567
(225) 924-1930
(225) 924-2620

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
0202214433
VA
183500000X
Pharmacist
Primary
17027
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0202214433
VIRGINIA BOARD OF PHARMACY
VA
01
17027
LOUISIANA BOARD OF PHARMACY
LA
Enumeration date
02/15/2016
Last updated
02/15/2016
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