Johnson, Eddie D.
Johnson, Eddie D. is an individual health care provider with primary practice located at 2508 Bert Kouns Loop Suite 102, Shreveport LA 71118-3133. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Johnson, Eddie D. can be contacted via phone (318) 671-1291.Contact Information
Primary practice address
2508 Bert Kouns Loop Suite 102
Shreveport LA 71118-3133
Phone: (318) 671-1291
Fax: (318) 688-6014
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 013614 | Louisiana |
Profile Details
| NPI number | 1275514978 |
|---|---|
| LBN Legal business name | Johnson, Eddie D. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 9th, 2005 |
| Last updated | Dec 28th, 2007 - about 19 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 | 1275514978 | NPPES |
| Louisiana | MEDICAID | 1180289 |
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