Individual
WALTER HARVEY JOHNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
12619
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000083871
—
AL
01
—
00014896
MISSISSIPPI MEDICAID
AL
01
—
22070
HEALTHSPRING
AL
01
—
2510133
UHC
AL
01
—
51083871
BC BS
AL
01
—
5283380
AETNA
AL
01
—
C76721
VIVA
—
Enumeration date
06/26/2006
Last updated
01/09/2015
Update your record
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