Johnson, Eddie Glen

Johnson, Eddie Glen is an sole proprietor health care provider with primary practice located at 7330 Fern Ave Ste 1103 , Shreveport LA 71105-4989. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Johnson, Eddie Glen can be contacted via phone (318) 798-0635.

Contact Information

Primary practice address
7330 Fern Ave Ste 1103 Shreveport LA 71105-4989
Phone: (318) 798-0635
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 013312 Louisiana

Profile Details

NPI number 1962738500
LBN Legal business name Johnson, Eddie Glen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 1st, 2009
Last updated Nov 1st, 2009 - about 17 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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