| NPI | 1720070824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM H JOHNSON Doctor/Owner 985-384-1562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 016985) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 12846B) |
| 208600000X Surgery (Licence: LA 02397R) | |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2020-08-22 |