Johnson, Juantina Mechelle

Johnson, Juantina Mechelle is an individual health care provider with primary practice located at 210 Hospital Cir , Choctaw MS 39350-6781. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Johnson, Juantina Mechelle can be contacted via phone (601) 389-6302.

Contact Information

Primary practice address
210 Hospital Cir Choctaw MS 39350-6781
Phone: (601) 389-6302
Fax: (601) 663-7924
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X MD026588 Louisiana
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 21445 Mississippi
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 21445 Mississippi

Profile Details

NPI number 1285683342
LBN Legal business name Johnson, Juantina Mechelle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 8th, 2006
Last updated Apr 22nd, 2014 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285683342 NPPES
Mississippi MEDICAID 01504386

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