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Individual

JERRY LAMAR JOHNSTON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
309 JACKSON ST, MONROE, LA 71201-7407
(318) 966-4000
Mailing address
101 CATALPA ST, MONROE, LA 71201-7418
(318) 245-1863

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
326872
LA
207L00000X
Anesthesiology Physician
85513
SC
207L00000X
Anesthesiology Physician
E-13627
AR

Other

Enumeration date
03/31/2016
Last updated
10/05/2023
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