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1962738500
EDDIE GLEN JOHNSON
SHREVEPORT, LA
NPI
1962738500
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
208D00000X General Practice
(Licence: LA 013312)
Enumeration Date
2009-11-01
Last Update Date
2009-11-01
Business Address
Dr. EDDIE GLEN JOHNSON M.D.
7330 FERN AVE STE 1103
SHREVEPORT, LA 71105-4989
Phone number: 318-798-0635
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Mailing Address
Dr. EDDIE GLEN JOHNSON M.D.
107 GRAYSON CIR
BOSSIER CITY, LA 71112-8605
Phone number: 318-458-2756
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