Johnson, Charles David
Johnson, Charles David is an individual health care provider with primary practice located at 6051 U S Highway 49 , Hattiesburg MS 39401-7200. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as his primary health care specialty. Johnson, Charles David can be contacted via phone (601) 288-7000.Contact Information
Primary practice address
6051 U S Highway 49
Hattiesburg MS 39401-7200
Phone: (601) 288-7000
Fax: (601) 450-0518
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Acute Care | 363LA2100X | R875364 | Mississippi |
Profile Details
| NPI number | 1437538410 |
|---|---|
| LBN Legal business name | Johnson, Charles David |
| Credentials | AGACNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 24th, 2015 |
| Last updated | Jul 28th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437538410 | NPPES |
| Mississippi | MEDICAID | 03600303 |
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