Johnson, William Walter

Johnson, William Walter is an sole proprietor health care provider with primary practice located at 1935 Lakeland Dr Ste 900 , Jackson MS 39216-5028. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Johnson, William Walter can be contacted via phone (601) 840-1454.

Contact Information

Primary practice address
1935 Lakeland Dr Ste 900 Jackson MS 39216-5028
Phone: (601) 840-1454
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 14886 Mississippi

Profile Details

NPI number 1053315028
LBN Legal business name Johnson, William Walter
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 8th, 2005
Last updated Jul 28th, 2021 - about 3 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 1053315028 NPPES
Mississippi MEDICAID 09015923
Mississippi Other 743030196
Mississippi MEDICAID 00117218

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