Individual
JACOB MARC JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
243 CURTISS RD, BARKSDALE AFB, LA 71110-2425
(318) 456-6555
Mailing address
243 CURTISS RD, BARKSDALE AFB, LA 71110-2425
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/07/2023
Last updated
10/10/2024
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