Individual provider · Type 1 NPI

Eddie Glen Johnson Iii, MD

General Practice Physician · Shreveport, LA

NPI number 1962738500 Active

Practice location

7330 Fern Ave Ste 1103
Shreveport, LA 71105-4989

Call (318) 798-0635 Map

Mailing address

107 Grayson Cir
Bossier City, LA 71112-8605

Specialties and licenses

TaxonomyCodeLicense
General Practice Physician Primary 208D00000X013312 (LA)

General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

6 other providers at this address

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About NPI 1962738500

Eddie Glen Johnson Iii, MD's National Provider Identifier is 1962738500, issued on Nov 1, 2009. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Shreveport, LA. The record was last updated on Nov 1, 2009.