Doctor Name: | GEORGE REGINALD JOHNSON |
NPI Number: | 1265760482 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 194 Midway Estates Dr Terry, MS - 391708488 |
Business Phone Number: | 6018780487 |
Business Fax Number: | 6018159804 |
Mailing Address: | Po Box 1939, JACKSON |
State: | MS |
Postal Code: | 392151939 |
Phone Number: | 6016729685 |
Fax Number: | 6018159804 |
NPI Enumeration Date: | 11/29/2009 |
NPI Last Update Date: | 11/29/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171W00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Contractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |