| Doctor Name: | MARISA JOHNSON |
| NPI Number: | 1083615520 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | L6967 |
| Business Practice Address: | 1303 Line Ave Ste 400 Shreveport, LA - 711014628 |
| Business Phone Number: | 3182212707 |
| Business Fax Number: | 3132212709 |
| Mailing Address: | 1303 Line Ave, Ste 400 SHREVEPORT |
| State: | LA |
| Postal Code: | 711014628 |
| Phone Number: | 3182212707 |
| Fax Number: | 3132212709 |
| NPI Enumeration Date: | 08/09/2005 |
| NPI Last Update Date: | 02/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RN0300X |
| License Number: | L6967 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Nephrology |
| Taxonomy Definition: | An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |