Individual
JOHN ALDEN JOHNSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5660
(601) 268-5759
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5660
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
12130
MS
208600000X
Surgery Physician
R4429
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04431870
—
MS
05
—
123146001
—
AR
01
—
4344773
CIGNA
MS
01
—
4594666
AETNA
MS
01
—
6027328
HEALTHSPRINGS
MS
Enumeration date
04/13/2006
Last updated
08/03/2020
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